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Serum Human Chorionic Gonadotrophin Hormone (HCG )Test

Last updated: February 8, 2026 Medically reviewed by: RxHarun Orthopedic Specialist Doctor Reading time: 7 min read

The human chorionic gonadotropin (hCG) test is done to measure the amount of the hormone hCG in blood or urine to see if a woman is pregnant. HCG may also be measured to see if cancer of the ovaries or testicles is present.

A qualitative HCG blood test checks if there is a hormone called human chorionic gonadotropin in your blood. HCG is a hormone produced in the body during pregnancy.

Other HCG tests include:

  • HCG urine test
  • Quantitative pregnancy test (checks the specific level of HCG in your blood)

Human chorionic gonadotropin is a hormone produced primarily by syncytiotrophoblastic cells of the placenta during pregnancy. The hormone stimulates the corpus luteum to produce progesterone to maintain the pregnancy. Smaller amounts of hCG are also produced in the pituitary gland, the liver, and the colon. As previously mentioned, certain malignancies can also produce either hCG or hCG-related hormones. Trophoblastic cancers (hydatidiform mole, choriocarcinoma, and germ cell tumors) are associated with high serum levels of hCG-related molecules.

Another Name

Human chorionic gonadotrophin – serum – qualitative; Pregnancy test – blood – qualitative; Serum HCG – qualitative; HCG in blood serum – qualitative

How the Test is Performed

A blood sample is needed. This is most often taken from a vein. The procedure is called venipuncture.

Urine Testing

  • Urine should not be collected after the patient has been drinking a large amount of fluid, as a dilute specimen may result in a falsely negative test.
  • Blood in the urine may cause a false positive test result.

Serum Testing

  • Peripheral blood can be obtained for a serum hCG test.

How to Prepare for the Test

No special preparation is needed.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing.

Why the Test is Performed

Most often, this test is performed to determine if you are pregnant. HCG level in the blood may also be high in women with certain types of ovarian tumors or in men with testicular tumors.

Normal Results

The test result will be reported as negative or positive.

  • The test is negative if you are not pregnant.
  • The test is positive if you are pregnant.

What Abnormal Results Mean

If your blood HCG is positive and you DO NOT have a pregnancy properly implanted in the uterus, it may indicate:

  • Ectopic pregnancy
  • Miscarriage
  • Testicular cancer (in men)
  • Trophoblastic tumor
  • Hydatidiform mole
  • Ovarian cancer

Interfering Factors

There are multiple reasons why an hCG test (serum or urine) may have a false report. While uncommon, false-positive hCG tests can result in unnecessary medical care and/or irreversible surgical procedures. False negatives may be equally concerning and result in a delay in care or diagnostic evaluation. Potential causes of false results are listed and briefly discussed.

Serum False Positives (1/1000 to 1/10,000) 

  • Ectopic production of hCG (hydatidiform mole, choriocarcinoma, and germ cell tumors,, in addition to multiple myeloma, stomach, liver, lung, bladder, pancreatic, breast, colon, cervical, and endometrial cancers)
  • Heterophile antibodies (autoantibodies and antibodies formed after exposure to animal products that interact with the assay antibodies)
  • Rheumatoid factors (can bind the antibodies in the assay as well)
  • IgA deficiency
  • Chronic renal failure or ESRD on hemodialysis (rare)
  • Red blood cell or plasma transfusion of blood with hCG in it have been reported
  • Exogenous hCG preparations for weight loss, assisted reproduction, doping

Serum False Negatives

  • Early measurement after conception
  • “Hook effect” can occur when hCG levels are about 500,000 mIU/mL. This is because there are so many hCG molecules that they saturate both the tracer and the antibodies separately, which doesn’t allow for the sandwiching of the tracer-hCG-antibody required for the measurement. This means that all of the complexes are washed away, giving a false-negative result. If the gestational trophoblastic disease is suspected, the lab should perform a dilution prior to testing.

Urine False Positives

  • Blood or protein in the urine
  • Human error in result interpretation
  • Ectopic production of hCG
  • Exogenous hCG
  • Drugs (aspirin, carbamazepine, methadone, high urinary pH, and seminal fluid)

Urine False Negatives

  • Early measurement after conception
  • Dilute urine specimen
  • “Hook effect” as discussed above

Risks

Risks of having blood drawn are slight, but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Blood accumulating under the skin (hematoma)
  • Infection (a slight risk any time the skin is broken)

Considerations

False-positive tests may occur when certain hormones are increased, such as after menopause or when taking hormone supplements.

A pregnancy test is considered to be very accurate. When the test is negative but pregnancy is still suspected, the test should be repeated in 1 week.

FAQ

What is a chorionic gonadotropin test for?

  • The human chorionic gonadotropin (hCG) test is done to check for the hormone hCG in blood or urine. Some hCG tests measure the exact amount. Some just check to see if the hormone is present. HCG is made by the placenta during pregnancy.

What does a positive human chorionic gonadotropin mean?

  • A positive beta-human chorionic gonadotropin (hCG) level usually means that you are pregnant. Pregnancy tests detect the hCG hormone in the blood and urine. The beta hCG levels are also measured using a test known as quantitative hCG testing.

What hCG level indicates pregnancy?

  • An hCG level of less than 5 mIU/mL is considered negative for pregnancy, and anything above 25 mIU/mL is considered positive for pregnancy. An hCG level between 6 and 24 mIU/mL is considered a grey area, and you’ll likely need to be retested to see if your levels rise to confirm a pregnancy.

What is a normal serum hCG level?

  • Normal levels are found in Non-pregnant women: less than 5 mIU/mL. Healthy men: less than 2 mIU/mL.

What are gonadotropins used for?

  • Gonadotropins usually are used during fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Injections of gonadotropins are started early in the menstrual cycle to cause multiple eggs to grow to a mature size.

What are the symptoms of rising hCG levels?

  • In the first 2 weeks, women may experience light spotting, breast soreness, mood swings, nausea, or bloating. These symptoms are due to an increase in an important hormone called human chorionic gonadotropin (hCG).

Can you have hCG and not be pregnant?

  • An elevated β-hCG in the absence of viable pregnancy can occur for multiple reasons and has a broad differential diagnosis including miscarriage, ectopic pregnancy, pituitary hCG production, trophoblastic disease, and phantom hCG.

What’s the normal hCG level at 4 weeks?

Standard hCG levels
Pregnancy weekStandard hCG range
3 weeks5–50 mIU/mL
4 weeks5–426 mIU/mL
5 weeks18–7,340 mIU/mL
6 weeks1,080–56,500 mIU/mL
7–8 weeks7,650–229,000 mIU/mL
9–12 weeks25,700–288,000 mIU/mL
13–16 weeks13,300–254,000 mIU/mL
17–24 weeks4,060–165,400 mIU/mL
25–40 weeks3,640–117,000 mIU/mL

What is the hCG level at 1 week?

  • Average hCG levels: Less than 10 U/L in non-pregnant women. 10 to 25 U/L for a ‘borderline’ pregnancy result. more than 25 U/L for a positive result.

What does 3 mean on the hCG blood test?

  • Expected hCG Levels in the First Trimester. Time Since Last Period. hCG Range (if Pregnant) 3 Weeks.

What causes hCG levels to rise if not pregnant?

  • Although the most common cause of an elevated HCG level in females is pregnancy, occasionally, an HCG-secreting tumor is suspected and other conditions such as gestational trophoblastic disease (GTD), nontrophoblastic neoplasms, or a pituitary source of HCG, must be considered.

How fast should hCG rise?

  • The levels of hCG rise rapidly in the earliest days of pregnancy and can be detected around eight days after the estimated day of conception in the blood by the most sensitive laboratory methods. Home pregnancy tests can detect it a few days later in urine depending on their sensitivity.

What can I eat to increase my hCG levels?

  • Some FruitsLimited oranges, strawberries, apples, and red grapefruit. Nonstarchy Vegetables Lettuce, celery, cabbage, cucumbers, onions, and tomatoes. Lean Meat Chicken breast, lean ground beef, shrimp, lobster, and whitefish.

Can vitamins affect hCG levels?

  • Biotin Found in Multivitamins May Interferes with Important Lab Tests Including hCG and Troponin Levels.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area later with a custom field named _rx_references.

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Written by Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

Dr. Md. Harun Ar Rashid, MPH, MD, PhD, is a highly respected medical specialist celebrated for his exceptional clinical expertise and unwavering commitment to patient care. With advanced qualifications including MPH, MD, and PhD, he integrates cutting-edge research with a compassionate approach to medicine, ensuring that every patient receives personalized and effective treatment. His extensive training and hands-on experience enable him to diagnose complex conditions accurately and develop innovative treatment strategies tailored to individual needs. In addition to his clinical practice, Dr. Harun Ar Rashid is dedicated to medical education and research, writing and inventory creative thinking, innovative idea, critical care managementing make in his community to outreach, often participating in initiatives that promote health awareness and advance medical knowledge. His career is a testament to the high standards represented by his credentials, and he continues to contribute significantly to his field, driving improvements in both patient outcomes and healthcare practices. Born and educated in Bangladesh, Dr. Rashid earned his BPT from the University of Dhaka before pursuing postgraduate training internationally. He completed his MD in Internal Medicine at King’s College London, where he developed a special interest in inflammatory arthritis and metabolic bone disease. He then undertook a PhD in Orthopedic Science at the University of Oxford, conducting pioneering research on cytokine signaling pathways in rheumatoid arthritis. Following his doctoral studies, Dr. Rashid returned to clinical work with a fellowship in interventional pain management at the Rx University School of Medicine, refining his skills in image-guided joint injections and minimally invasive pain-relief techniques.