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You’ve probably heard the old adage that you can’t be “a little bit pregnant.” The idea is that being pregnant — or not pregnant — is a binary thing, with “yes” or “no” being the only answer to that question. At-home pregnancy tests support that idea: You either see a second pink line or you don’t…or, in the case of digital tests, you either see the word “pregnant” or “not pregnant.”
But what many people don’t realize is that the hormone that turns those pregnancy tests positive can be measured quantitatively with a blood pregnancy test, meaning it can identify the precise concentration of hCG in your blood.
So, while an at-home pregnancy test may give you a sense of where your levels lie, the only way to know your exact hCG level in early pregnancy is by having your blood tested. Generally, this happens in a doctor’s office, which gives providers the ability to learn more about a pregnancy. But patients can also gain access to their quantitative hCG levels on their own without having to wait for an appointment.
Accessing these results is simple and accessible: Labcorp OnDemand offers quantitative hCG pregnancy testing at an affordable price point without needing to schedule a healthcare provider visit. Testing can be done at one of Labcorp's 2,000+ Patient Service Centers, including over 400 Walgreens locations, with results delivered to your inbox the next business day.
Measuring your hCG levels in early pregnancy can give you insight into your pregnancy — but some background information is necessary to make sense of those results, and that’s where expertise from Lisa Richards, MSN, CNM (Certified Nurse Midwife), comes in handy.
How exactly can people interpret the results of these tests? And what’s the value of quantitative beta-hCG testing? Richards breaks down everything you need to know about hCG levels. But first, let’s back it up a bit.
What is hCG, exactly?
“Beta-hCG – or human chorionic gonadotropin – is sometimes referred to as ‘the pregnancy hormone’. Although many hormone levels change in pregnancy, hCG is generally considered pregnancy-specific since it’s only produced during pregnancy (or in rare cases by abnormalities like certain tumors),” says Richards. “It is the hormone measured by both home pregnancy tests and pregnancy blood tests.”
When is hCG produced?
“Production of hCG begins very early in pregnancy, and is usually detectable in a person’s blood and urine by about 10-14 days after an egg is fertilized, shortly after an embryo has implanted in the womb,” says Richards. “In very early pregnancy, hCG is specifically produced by the cells that will become the placenta, and later on, it’s produced by the placenta itself.
The value of knowing your hCG levels
For one thing, quantitative testing provides a more accurate answer to the all-important question “Am I pregnant?”. False positive pregnancy tests are very rare, but false negatives on home pregnancy tests are not.
“Usually, knowing your exact hCG level may not be necessary, and some healthcare providers may not test or check hCG in all pregnancies,” says Richards. “However, if your healthcare provider does check your hCG, it can be helpful to have an understanding of what your results mean.”
According to Richards, knowing your hCG level can help you understand if your level is appropriate based on where you are in your pregnancy.
What’s a normal beta-hCG level in early pregnancy?
“Levels of hCG start very low and then get much higher over the first few weeks of pregnancy, generally rising at a predictable rate. When looking at reference ranges for what’s normal, it’s important to know both how far along in pregnancy a person is and to understand that there can be a very wide range of normal. For example, during the fifth week of pregnancy levels around 200 mIU/mL and over 6,000 mIU/mL might both be normal,” says Richards.
But the progression of those levels is more telling. “In a healthy pregnancy that’s developing normally, hcg levels generally double about every 24-48 hours early in the first trimester,” adds Richards. “After six or seven weeks of pregnancy, that rate of increase slows to double every 72-96 hours. Levels reach a peak late in the first trimester and then start to fall.”
This progression offers insight into the health of a pregnancy, which is why providers offer measure levels twice.
But these levels don’t continue to rise throughout an entire pregnancy.
“Levels of hCG peak around the 10th week of pregnancy,” says Richards. “After that, they usually drop slowly toward the end of the first trimester and into the second trimester of pregnancy before reaching a plateau. Generally, the levels stay at that plateau level throughout the rest of pregnancy until after birth. In a healthy pregnancy, it’s generally unusual to have hCG levels checked past the first trimester.”
This explains why morning sickness typically (and mercifully) peaks around that 10-week mark before tapering off at the end of the first trimester — the hCG hormone is actually responsible for those symptoms.
What do low hCG levels indicate?
According to Richards, a level under 5 is too low to indicate a pregnancy. Low levels, along with levels that don’t progress as expected, could indicate an imminent miscarriage or an unhealthy pregnancy. The amount of time it takes for hCG to decline after a miscarriage can vary as well, so there may be some in a person’s system after a pregnancy loss.
What do very high hCG levels indicate?
“High levels of hCG, or a very high rate of increase, can indicate a couple of different possibilities: One possibility is a twin (or higher order multiple) pregnancy. In the case of twins or multiples, each developing fetus (and its placenta) produces its own hCG, which results in higher levels overall,” says Richards.
“Another possibility with high hCG levels is something called trophoblastic disease, also known as a molar pregnancy. In this situation, there’s an overgrowth of clusters of placenta-like cells. These cells produce hCG, but can’t result in a normal pregnancy,” she adds. “Higher than average hCG levels can also sometimes be more likely when the developing fetus has certain conditions, like Down Syndrome.”
Either way, additional testing, like ultrasounds or genetic tests, must be issued to determine if any of these scenarios are present.
What do hCG levels look like when someone conceives via IVF?
“Overall, hCG levels and their rate of increase are about the same for pregnancies conceived via IVF. In some cases, the rate of increase might be slightly higher at first for a fresh embryo transfer than a frozen embryo transfer,” says Richards.
Can hCG levels tell you your baby’s sex?
Well…not really.
“Statistically speaking, someone carrying a female baby has slightly higher hCG levels than someone carrying a male baby,” says Richards. However, hCG levels can’t accurately be used to predict a baby’s sex. Since there’s a very wide range of normal hCG levels and only about a 10% variance based on a baby’s sex, someone with higher-than-average hCG could be carrying a male baby and someone with lower-than-average levels could still be expecting a female.”
Learn more about Labcorp OnDemand’s quantitative hCG pregnancy test here.
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, Marie Claire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.