hCG & Its Role In Miscarriage (Part 1)

By now we know that human chorionic gonadotropin (hCG), or the “pregnancy hormone”, has a vital role in your pregnancy – from the time of confirming to maintaining it!

So, how does hCG play a role in a miscarriage?

In early pregnancy,  two hormones tend to increase in the mother’s body post-implantation, they are progesterone and hCG. In pregnant women, their levels rise as the pregnancy progresses and if it fails to do so it indicates an impending miscarriage (loss of the fetus before 24 weeks of gestation).  In this article, we emphasize the importance of hCG levels in miscarriage by assessing the hCG doubling time.

So, how are the levels of hCG measured?

The main types of  hCG blood test include:

  1. Qualitative (measures the presence/absence of hCG)
  2. Quantitative ( measures the precise amount of hCG)

A qualitative hCG test is done in a urine pregnancy test (UPT) which helps in confirming a pregnancy by the presence/absence of hCG in the urine sample.

A qualitative hCG test, which is done to assess the pregnancy by evaluating the mother’s blood sample. This is mainly done when there is:

The most common type of quantitative test to assess a miscarriage is the serial hCG blood test.

What is a serial hCG blood test?

In serial hCG blood test, the hCG doubling time is measured. Normally, measuring hCG are a good way to check whether a pregnancy is going ahead normally (checked around  6 to 7 weeks after your last menstrual period) as the hCG levels double every 72 hours. hCG then peaks during the first 8 to 11 weeks of your pregnancy, then starts to decline and eventually plateau.

Serial hCG blood tests are generally done between 2-3 days to assess the hCG doubling time. One single hCG value (which is low) is inconclusive. If there is a reduction in the hCG levels on serial hCG blood test, then it can indicate a future miscarriage or an ectopic pregnancy.

After week 5 to 6 of gestation, ultrasound is the best tool for knowing about the progression of your pregnancy and is much more accurate than the hCG levels.

We will get to know more about the role of hCG in a miscarriage in the continuing part-2 of this article.




Dr. Aishwarya Rajeev has completed her MDS degree and is currently pursuing her PhD. She is an avid reader and loves to teach and write!

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