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During pregnancy, you will experience a change in many of your hormone lab values.
But did you know that by the 10th week of pregnancy, your hCG levels could be as high as 170,409 mIU/mL?
This is a large number considering your starting hCG level was probably 0!
Why and how does hCG increase so rapidly?
hCG levels double approximately every 48 hours for the first 6-7 weeks of pregnancy. This is known as hCG doubling and is important to maintain a healthy pregnancy.
Since hCG is vital for a healthy pregnancy, you may be wondering about your levels. Or maybe you’ve been on one too many TTC forums, and now you’re convinced you’re having twins based on your hCG level!
In any case, we will review everything you need to know about hCG doubling in pregnancy. We’ll cover what hCG levels are normal and possible causes of abnormal hCG levels.
First, let’s review why hCG is important during pregnancy.
Key Takeaways
- hCG doubles approximately every 48 hours during pregnancy for the first 6-7 weeks.
- hCG levels reach their peak at around week 10 of pregnancy. After this, they plateau.
- Low hCG levels could indicate miscarriage, ectopic pregnancy, or anembryonic pregnancy
- High hCG levels in pregnancy could indicate multiple gestation or molar pregnancy.
- Declining hCG levels signal a nonviable pregnancy.
- hCG levels may rise at a lower rate and still result in a successful pregnancy.
- There is no supplement or home remedy to ensure hCG doubling.
Importance of hCG in Pregnancy
Human chorionic gonadotropin (hCG) is also known as the “pregnancy hormone” and it plays a crucial role in maintaining a healthy pregnancy. The main role of hCG is to stimulate the corpus luteum to produce progesterone.
Progesterone and hCG both play a vital role in pregnancy. And to confirm if you are pregnant, you must take a pregnancy test.
When you take a pregnancy test, whether at home or the doctor’s office, it tests for the presence of beta hCG. Hormones such as hCG, LH, FSH, and TSH are made up of alpha and beta subunits. The alpha subunits are identical for each hormone. Their beta subunits are what give them their unique characteristics. This means beta hCG is more specific.
Beta hCG tests can be qualitative or quantitative.
- Qualitative test– tests for the presence of hCG (think at-home urine test)
- Quantitative test– tests for how much hCG is present
At-home pregnancy tests can confirm pregnancy. If more than 20 mIU/mL is detected, you’ll receive a positive pregnancy test. But only blood tests can help determine if a pregnancy is going as expected. hCG levels must be tracked and trended. One hCG test will not give you an accurate illustration of how your pregnancy is going.
Serial hCG levels will clue you into if you’re experiencing the following:
- Healthy pregnancy
- Ectopic pregnancy
- Molar pregnancy
- Miscarriage
hCG levels are also measured in non-pregnancy-related cases such as ovarian, bladder, and testicular cancer.
So what should you expect your hCG levels to be during pregnancy?
See how your hormone chart might look like!
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Normal hCG Levels in Pregnancy
Once your baby nestles itself into your uterine lining (implantation), the placenta starts to secrete hCG. The starting level of hCG is usually 0 mIU/mL.
From here, hCG values should double every 48 hours during the first 6-7 weeks of pregnancy. hCG doubling time is correlated to the viability of the pregnancy. If hCG is not increasing at an expected rate, there could be an issue.
Note– As pregnancy progresses, the doubling time slows down. Your hCG levels will not continue to double every 48 hours for the entire pregnancy. Can you imagine how high your hCG levels would be if they did?
Take a look at the hCG doubling time chart below. You can see a wide range of what is considered normal hCG levels by week.
hCG levels rise rapidly and peak around week 10 of pregnancy. From here, the levels plateau.
Again, the numerical value is not as important as the rate at which the levels increase.
The highest rate of increase is seen during the first couple of days after implantation. You can see in the table below that hCG levels in the urine are shown to increase 3-fold two days after implantation!
Importance of hCG Doubling
hCG doubling in the first 7 weeks of pregnancy signals that your pregnancy is developing normally. hCG that rises outside of this range could signal an underlying problem.
The following are a few possible causes if hCG is rising slower than expected:
- Ectopic pregnancy: A pregnancy that occurs in a location other than the uterus (eg. the fallopian tubes, the ovaries, etc.)
- Impending miscarriage
- Anembryonic pregnancy: this is a pregnancy where a gestational sac is present but there is no embryo detected on ultrasound
Here are a few possible causes if hCG is rising higher than expected:
- Multiple pregnancy– Twins, triplets, quadruplets, oh my!
- Molar pregnancy– This is a rare type of pregnancy complication that results in a noncancerous mass/tumor. Sometimes a fetus is present at the beginning of the pregnancy and miscarries, sometimes there is no fetus at all. The “cluster of grapes” mass secretes high levels of hCG.
- You may be farther along in your pregnancy than predicted.
If hCG values are declining, then unfortunately, the pregnancy is non-viable and will end in a miscarriage.
Learn more: HCG and Miscarriage: What do they mean?
Please note- while hCG doubling is the standard, not all women will experience it during a healthy pregnancy.
Some women will have hCG levels that increase at lower levels. Studies show the minimum increase should be 66% for a viable pregnancy.
hCG alone does not paint the whole picture of whether a pregnancy is viable. One study showed that if hCG alone is used to predict the risk of miscarriage, the accuracy was only 44.72%. Other tests should be used, such as ultrasound or blood tests, along with hCG for confirmation
How Can I Make Sure My hCG Levels Keep Doubling?
You cannot control your hCG levels. There’s no DIY or home remedy to increase your levels.
If there is an underlying problem affecting your hCG levels, you should work closely with your OB/GYN to address the issue.
FAQs
Yes, in some cases your hCG levels will rise more slowly and you will go on to have a successful pregnancy. The minimum level that hCG levels need to rise is 66% over 48 hours.
High hCG and doubling hCG does not mean you have a lesser chance of miscarriage. There’s a huge range of what is considered a normal hCG level. This means the value does not matter as much as the rate at which your values are increasing. Miscarriage becomes a concern when your hCG levels decline or are not rising at the expected rate.
hCG levels rise at an accelerated rate after implantation. hCG levels are shown to increase 3 fold in the first few days. Usually around 1.6-3 fold during the first week. Interestingly, the day of implantation might affect your hCG levels and how quickly they rise. hCG may rise quicker if implantation occurs early (7 DPO or earlier). If implantation occurs later (10 DPO or later), hCG levels tend to be lower. However, this is not a reflection of the viability of your pregnancy.
One hCG level cannot determine if you are having a miscarriage. Declining hCG levels, however, likely will result in a miscarriage. If you are worried about your hCG level or you think you might be having a miscarriage, consult your doctor.
hCG doubling begins to slow down around 6-7 weeks of pregnancy. And after week 10, hCG levels plateau.
Since the main role of hCG is to stimulate the corpus luteum to make progesterone, you may wonder if you should take a progesterone supplement. Women have been given progesterone for luteal phase support in IVF and embryo transfer, but many experienced side effects. hCG supplementation is a viable alternative in such cases. hCG after intrauterine insemination (IUI) has been shown to improve pregnancy outcomes.
During the first 10 weeks of pregnancy, your hCG levels change daily. Approximately every 48 hours your hCG levels will double in value.
hCG doubling is a positive sign your pregnancy is developing at a normal pace. Bleeding during pregnancy can be benign or may indicate an underlying condition. Please consult your OB/GYN if you are bleeding during pregnancy.
Yes, doubling hCG levels is a good sign for a healthy pregnancy for the first 6 – 7 weeks of pregnancy. After 7 weeks, hCG begins to slow down and usually plateaus around week 10. That said, every pregnancy is different and exact hCG levels can vary quite a bit. Also keep in mind that hCG values aren’t the only indicator of a healthy pregnancy. An audible heartbeat and a visible sac on an ultrasound can help with confirming the health of a pregnancy.
Exact hCG values at 5 weeks can vary a good amount from woman to woman and pregnancy to pregnancy. The range of normal hCG values at 5 weeks of gestation is 217-8,245 mIU/mL. The more important factor to look at, though, is the trend of hCG rise.
For most pregnancies, hCG values nearly double every 48 hours for the first 7 weeks of pregnancy. However, some studies show that hCG should increase at least by 66% every 48 hours for a viable pregnancy. The exception is with multiple pregnancies, which may see even more rapid doubling rates.
Note: If hCG is doubling too rapidly it could be a sign of a molar pregnancy. If hCG is rising too slowly it could be a sign of an ectopic pregnancy, anembryonic pregnancy, or a potential miscarriage.
In some pregnancies, hCG that’s rising but not fully doubling every 2 days isn’t always a cause for concern. It could mean that the dating of your gestational age is off slightly or that you just have slightly lower rising hCG levels but an otherwise normal pregnancy. Not every pregnancy follows exact hCG doubling standards to a tee. That said, if your hCG is rising much slower than expected, it could indicate:
- An impending miscarriage
- An ectopic pregnancy
- An anembryonic pregnancy (when there’s only a gestational sac but no embryo)
Know more: Pregnant But hCG Rising Slowly: What to Know
No, folic acid is not known to increase hCG levels. Folic acid is recommended to take as a supplement prior to pregnancy and during early pregnancy to help prevent the baby from developing neural tube defects. It has no effect on a pregnancy’s hCG levels.
According to one study, at 5 weeks pregnant (around 21 DPO), the blood hCG level for twins is expected to fall between 2896 – 4303 mIU/mL. To put this in perspective, the typical level for a singleton pregnancy at 5 weeks is 1929 – 2867 mIU/mL.
A good blood hCG level for 7 weeks pregnant is likely to fall between 4,059 – 153,767 mIU/mL. Keep in mind that this range could vary a bit more if the gestational age wasn’t dated accurately or if it’s a multiple pregnancy.
Foods that are rich in folate include:
- Leafy greens
- Citrus fruits
- Legumes like peas, beans, and lentils
- Eggs
- Beets
- Asparagus
- Broccoli
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