Pathology Consultation on Human Chorionic Gonadotropin Testing for Pregnancy Assessment

Objectives: To provide clarity on the use of qualitative and quantitative human chorionic gonadotropin (hCG) tests for the assessment of pregnancy. Methods: A case scenario and a brief review of the relevant literature describing clinical and analytical considerations regarding hCG testing are presented. Results: In pregnancy, hCG is nearly always detectable in serum and urine within 16 days after ovulation. Serial hCG testing is valuable in the evaluation of suspected ectopic pregnancy. hCG assays vary in their analytical specificity, and qualitative tests may be less analytically sensitive than claimed. Erroneous hCG test results can occur for several reasons. Conclusions: hCG assays are reliable diagnostic tests for pregnancy assessment, but a clear understanding of their limitations is necessary for appropriate result interpretation.