Doubling time of human chorionic gonadotropin (hCG) in early normal pregnancy: relationship to hCG concentration and gestational age

Abstract

There is controversy regarding whether the doubling time of human chorionic gonadotropin (hCG) in early normal pregnancy is constant or rises with increasing gestational age (GA) and hCG concentration. To clarify the influence of these variables on hCG doubling time, we obtained serial blood specimens every 2 to 4 days between postovulatory day 12 and 70 from 16 women who conceived while monitoring basal body temperature. The serum concentration of beta-hCG was determined by radioimmunoassay. Serial doubling time of hCG was calculated in all subjects and correlated with GA and hCG concentration. Least-squares estimates of 95% confidence bands were established from regression analysis given the second hCG concentration for each pair of samples or GA. For elimination of the need for calculation and thus improvement of the clinical utility of doubling time determinations, a nomogram relating the concentrations of hCG in paired serum samples to doubling time was constructed. We observed a significant correlation of doubling time with hCG concentration and GA, both in the group overall and within each individual pregnancy. These data support the recommendation that doubling time determinations should be evaluated with reference to normal values for a given GA or hCG concentration and suggest that previously proposed normal values of doubling time in early normal pregnancy may be low.