Practical Session

Detection of hCG in urine

Physiology
Department
FK-KMK UGM
Human chorionic
gonadotropin
 What is hCG ?
  is a hormone produced by
the placenta after implantation
 Glycoprotein hormone
 The main function is to maintain
corpus luteum producing
progesterone --- to prepare the
implantation
 It can be found in urine and blood
 Similar structure with LH -- similar
function
 test for bHCG
 Qualitative :
Presence of hCG in blood and urine
of reproductive age women  Galli mainini

indicative of the presence of fetal  Quantitative

trophoblasts  ELISA, RIA
pregnancy or in neoplastic
Semi qualitative
disease
 hCG kit test kit/strip test
 Latex test
Production of beta- hCG

 7-8 days from fertilization, when blastocyte attach

to endometrium to form placenta consist of
cytothrophoblast and syncytiothrophoblast --
bhCG is produced by syncitiothrophoblast
 Blood levels increase rapidly, doubling every 2
days -- Urine concentration of hCG follows the
pattern of maternal plasma
 It can be detected 25-50 mIU/mL after
fertilization
 By strip test it can be detected
 By latex test will be detected at 200 mIU/mL
 Can be detected in post menopausal woman in
low level about 5 mIU/mL

hCG enters maternal blood at time of blastocyst implantation  urine  early pregnancy test
implantation
Secretion of the hCG is maximal
at 8 to 10 weeks of gestation

o Main function  rescue and maintenance of function of

the corpus luteum to continue production of
progesterone
o After 8-10 weeks of gestation, placenta produce enough
progesterone for maintaining pregnancy 
downregulate LH-HCG receptor in corpus luteum.
o Level of beta hCG is doubling and after day 2-3 of
missed period can reach 200 mIU/mL
o The level is higher in multiple pregnancy
o The peak level of bhCG is 80.000-100.000 mIU/mL
during 10 weeks of pregnancy.
o After 10 weeks of pregnancy the level will down, very
low when detected at 1 weeks after parturion. But still
found 2 month after parturition in multiple pregnancy
Function of hCG

1. Rescue and maintenance of function of the corpus luteum

(continued progesterone production) Other Fuctions
 about the 8th day after ovulation or 1 day after implantation- hCG  Induction of ovulation
takes over for the corpus luteum
2. Stimulation of fetal testicular testosterone secretion  Produce steroid hormone : estrogen,
 acts as an LH surrogate and stimulates replication of testicular Leydig progesterone, testosterone
cells and testosterone synthesis to promote male sexual
differentiation
 To prevent menstruation
3. Stimulation of maternal thyroid activity  To treat hypogonadism, undescensus testis
 hCG stimulates thyroid activity via the LH-hCG receptor and by the
TSH receptor
4. Promotion of relaxin secretion by the corpus luteum
5. Promote uterine vascular vasodilatation and myometrial
smooth muscle relaxation via LH-hCG receptors
After parturition
hCG and other placental hormone
Abnormal hcg
 Mola pregnancy
 Choriocarcinoma
 Carcinoma testis
Strip test
Compact test
Strip Test Results
Aglutination test results