What is the hCG level during pregnancy after IVF? HCG dynamics after IVF: what the test shows by day

Through in vitro fertilization, couples who are unable to conceive naturally can become parents. Human chorionic gonadotropin is a hormone produced by the membranes of the fetus. If the embryos have taken root, its level begins to grow rapidly, triggering the necessary processes in the woman’s body. At different times, it indicates how the pregnancy is progressing. What hCG indicator indicates a successful replantation? What are its dynamics in the future?

IVF procedure and embryo transfer

IVF is a reproductive technology that involves fertilizing an extracted egg under artificial conditions outside the mother’s body. Mature gametes are extracted from the ovaries by puncture and fertilized. The resulting blastocysts are grown for 3–5 days under special conditions, then transferred to the uterine cavity. Five-day ones usually take root better than three-day ones. The age of embryos for transfer is determined by the doctor individually.

HCG: what is it when it begins to be produced after embryo transfer?

Human chorionic gonadotropin is a hormone produced by the tissues of embryological membranes. The synthesis of hCG begins a few hours after implantation. The role of this compound is great: it promotes the production of other hormones necessary to maintain pregnancy, is responsible for the adaptation of the woman’s body to a new state, and prevents the involution of the corpus luteum. Determining the level of hCG allows you to establish the fact of pregnancy, estimate the number of fetuses and identify pathologies.

HCG level in early pregnancy after IVF in the table by day

The table shows the normal levels of human chorionic gonadotropin by day (DPP - day after transfer):

Age of the embryo (counted from the day of egg retrieval)	Three-day DPP	DPP five days	Hormone concentration
7	4	2	2–4
8	5	3	3–18
9	6	4	3–18
10	7	5	8–26
11	8	6	11–45
12	9	7	17–65
13	10	8	22–105
14	11	9	29–170
15	12	10	39–270
16	13	11	68–400
17	14	12	120–580
18	15	13	220–840
19	16	14	370–1300
20	17	15	520–2000

To increase the chances of success, not one embryo is implanted, but several at once, so multiple pregnancies with IVF are not uncommon. The level of the hormone in this case will be higher than the values indicated in the table, since it is produced by the chorions of not one, but several embryos at once. During pregnancy with twins, its concentration doubles on average; during pregnancy with triplets, it triples.

HCG norm by week in dynamics

During IVF, the hCG hormone begins to be produced after successful implantation, its amount doubles every 2 days. This dynamic continues for approximately 5 weeks. Then the growth rate slows down. Having reached a peak at 6–7 weeks from the day of conception, the hCG level gradually begins to decrease after the IVF procedure. It has not changed since the 20th week. After cryotransfer (transplantation of frozen embryos), the permissible concentration of hCG does not differ from normal values.

Normal hCG values during pregnancy by week after IVF are presented in the table:

A week from conception	HCG concentration minimum, U/l	HCG concentration maximum, U/l
2	25	300
3	1500	5000
4	10000	30000
5	20000	10000
6, 7, 8, 9, 10, 11,	20000	225000
12	19000	135000
13, 14,	18000	110000
5, 16,	12000	80000
17, 18, 19,	8000	58000
20, 21, 22, 23, 24, 25, 26, 27, 28	7000	49000

When is it time to donate blood for hCG?

You can talk about pregnancy after IVF only when the hCG concentration reaches 25 mU/ml, but the result is guaranteed to be 100 mU/ml.

Blood is not donated for hCG immediately after IVF, since the required concentration of the hormone is achieved only 10–14 days after embryo transfer. The analysis carried out earlier (5 DPP, 6 DPP, 7 DPP, 8 DPP, 9 DPP) is not indicative.

How to prepare for donating blood for testing?

A blood test for hCG after embryo transfer is done on an empty stomach, so the collection of material is usually scheduled for the morning. The last meal should be taken 8–12 hours before the procedure. Then you can only drink plain water. If you need to get tested urgently, abstaining from food should be at least 4-5 hours. The day before the test, you must avoid fatty and fried foods. It is important to avoid conflict situations and emotional overexcitation. Excessive physical activity is not recommended. 10–20 minutes before blood sampling, you need to sit down and calm down.

Why does hCG drop after embryo transfer?

A low concentration of the hormone after embryo transfer, including cryotransfer, may be a feature of the woman’s hormonal background. However, more often a deviation from the norm indicates pathologies:

Frozen pregnancy. It is characterized by a stop in the development of the embryo and its death. It is more often observed in the early stages in primiparous women who have reached the age of 30. Provoking factors are sexually transmitted infections, numerous abortions, hormonal imbalance. The diagnosis is confirmed by the absence of an increase in hCG levels or its decrease within 48 hours.
Intrauterine developmental delay of the embryo. Hormone concentrations below normal levels may indicate disturbances in fetal formation.
Ectopic pregnancy. With pathology, the fertilized egg is not fixed in the uterus, but in its cervix, fallopian tubes or peritoneal area. The hCG level plays an important role in diagnosing pathology. An anomaly is indicated by: an indicator above 1500 mIU/ml, a slow increase in hormone levels (less than 1.6 times in 2 days), and the absence of a fertilized egg in the uterus revealed by ultrasound. After 3–4 weeks, growth stops.
Risk of spontaneous abortion. Too low a hormone concentration may indicate a hormonal imbalance. If measures are not taken, spontaneous abortion may occur.

What to do if the hCG level is not normal?

An increase in hCG levels after IVF above normal may indicate pathologies. The reason for high levels of hCG in the body may be:

Diseases of the maternal endocrine system, including diabetes mellitus.
Hydatidiform mole (more details in the article: Hydatidiform mole: pathological anatomy of formation). The anomaly is characterized by the formation of bubbles with liquid inside from the chorionic villi, resembling bunches of grapes. Leads to fetal death and can transform into a malignant tumor - chorionic carcinoma, in which abnormal hCG levels are also observed.
Taking medications containing synthetic gestagens. In the body, these hormones are produced by the corpus luteum, placenta and adrenal glands and ensure the maintenance of pregnancy.
Fetal malformations, chromosomal abnormalities (Down, Klinefelter, Shereshevsky-Turner, Patau syndromes, pathologies of the neural tube structure). If there are congenital diseases in the fetus, the concentration of the hormone will increase rapidly, exceeding the norm by 2 or 3 times.
Multiple pregnancy.

If the hCG level does not correspond to the norm (the hCG table for days after IVF will help to detect it) is a reason to consult a doctor. In some cases, deviations are explained by physiological reasons and do not pose a danger.

Often, a discrepancy between the hCG level and the norm indicates dangerous conditions or a threat of miscarriage. Timely diagnosis and timely medical care can prevent the development of complications and maintain pregnancy.

The result of one hCG test cannot be the basis for making a diagnosis. To eliminate the possibility of error, the study is repeated and, if necessary, additional examinations are prescribed.

If the hormone level does not correspond to the hCG values that are considered normal after the IVF procedure, due to an ectopic, frozen pregnancy or hydatidiform mole, surgery is required to remove the fetus from the uterus or another location (see also: what is the hCG level in the early stages of an ectopic pregnancy ?). If you have diabetes, you need to follow a diet and, if necessary, prescribe insulin.

If fetal growth retardation is diagnosed, drugs are used that improve blood supply, antihypoxic and membrane-stabilizing medications that increase resistance to hypoxia. Treatment of threatened miscarriage is based on limiting physical activity and using hormonal drugs.

The desire to become a mother is natural for a woman, but if pregnancy does not occur, the IVF procedure comes to the rescue. After passing it, the woman anxiously awaits the appearance of the first signs showing that everything was successful. One of the most reliable indicators is the change in the level of hCG in the blood.

First signs of pregnancy

So, the preparation and the IVF procedure itself are behind us. Now everything depends on whether the embryo takes root in the uterus. The doctor will be able to tell for sure whether pregnancy has occurred or not in 10–14 days, but I want to know about this as early as possible. Therefore, women listen carefully to themselves, hoping to catch the first signs.

Early symptoms of pregnancy with IVF are the same as with pregnancy occurring naturally.

This may include morning sickness, slight drowsiness, and confusion during the day. Sometimes there is soreness in the mammary glands, a feeling that the breasts have enlarged, and in some cases urination becomes more frequent and nagging pain appears in the lower back. Some women experience a rise in body temperature, and this is not associated with a cold or infection. But during this period, a woman is especially vulnerable to various viruses, since her immunity decreases.

And of course everyone knows that Pregnant women experience changes in taste and smell preferences. Classic pickled cucumbers and herring are by no means a fiction, although more exotic desires may arise. And vice versa: the recently beloved aroma of freshly brewed coffee suddenly seems unpleasant, and the smell of a colleague’s perfume, which the woman had not noticed before, is too strong.

However, most of these signs are subjective, especially if the expected pregnancy is not only desired, but also long-awaited.

A more objective sign is a delay in the next menstruation and the appearance of minor bleeding a few days before its expected onset. Small amounts of blood may indicate that the embryo has attached to the uterine wall. Such discharge does not appear in all women, but if there are traces of blood in the usual leucorrhoea, you should immediately consult a doctor.

Features and meaning

An absolutely objective symptom of pregnancy is the level of the hormone human chorionic gonadotropin. It is often called the pregnancy hormone, since it begins to be produced after the implantation of the fertilized egg or, in the case of IVF, the implanted embryo into the wall of the uterus.

It is on this effect that all tests for determining pregnancy are based, including those sold in pharmacies and carried out at home. HCG shows the same two stripes that appear on a rapid test after contact with urine.

The level of hCG in the blood of a pregnant woman varies depending on the period and in the first days doubles literally every 48 hours.

Therefore, for ease of use, a special table has been compiled showing what level of the hormone should be in the blood or urine on a certain day.

If pregnancy occurs after IVF, then the woman knows exactly the duration and age of the embryo and can check hCG on her own by donating blood for analysis in any clinic or laboratory.

When should it be done?

According to the IVF protocol, hCG is tested 13-15 days after the transfer, but most often it is not necessary to wait that long; you can do the test without waiting for this period.

However, research shows that small amounts of hCG can be found in the blood of even a non-pregnant woman if she is over 40 years old. Therefore, ultra-sensitive tests can, unfortunately, show the desired result, even if pregnancy has not occurred.

For the test to be accurate, it should be carried out on the 7th day after the transfer, from this day - a week after IVF, and tables begin comparing the number of days after the transfer and the level of the hormone, and the test will show a more accurate result.

But even if the test turns out to be negative, you shouldn’t be upset. Only a doctor can interpret the results; in addition, it is important to monitor changes in hCG over time, i.e. carry out several tests. The fact is that in some women, even during pregnancy, the level of hCG is below the average values accepted as the norm. As the embryo develops, the rate also increases.

You can repeat the test in a day or two. With an increase in hCG levels, pregnancy is most likely to occur.

How does the level increase?

During IVF, an embryo is transferred into the uterus, the conception of which occurred in vitro, i.e. in a test tube. The age of the implanted embryo is counted from the moment of conception, and depends on what technology is used in a particular clinic.

However, research shows that when transferring five-day-old embryos, that is, embryos five days old, the likelihood of pregnancy increases. At an earlier age, it is not always possible to determine whether the embryo will develop.

Therefore, more and more often, IVF clinics are abandoning three-day periods, giving preference to more developed embryos.

The probability of success with IVF does not exceed 50%, even if the procedure went flawlessly, and during the waiting period the woman led a calm lifestyle prescribed by the doctor, counting down the days on the calendar. And it's not the technology's fault. During natural conception, not all embryos survive, and if they die, the woman will begin menstruation on time.

Therefore, during IVF, not one, but several embryos are transferred into the uterine cavity. With the improvement of technology, their number was reduced to 2–3. But during in vitro fertilization, a larger number of embryos are formed. The rest are frozen in case the IVF attempt does not bring the desired result and a decision is made to repeat it.

In preparation for repeated IVF, embryos are carefully thawed, raising the temperature to normal within a few minutes. Then the embryologist evaluates their condition and prepares viable ones for transfer. This procedure is called cryotransfer. According to statistics, only 10% of embryos do not have living cells after thawing.

If a woman ovulates naturally, then To determine the optimal date for repeat IVF, several ultrasounds are performed allowing to monitor the growth of the follicle in the ovary and the formation of the endometrium in the uterus. Next, an ovulation test is carried out and a small amount of drug support is given to create optimal conditions for implantation and development of the embryo. The embryo is transferred 3 or 5 days after ovulation - this depends on its age.

But it is not always possible for women who turn to IVF to experience natural, or, as doctors say, spontaneous ovulation. In this case its onset is stimulated using hormone replacement therapy. The patient is administered the necessary hormones, monitoring the thickness of the endometrium and follicle maturation using ultrasound. If it is possible to achieve ovulation, then a transfer or cryorepenosis is performed on days 3–5. In its absence, the count starts from the day of progesterone administration.

Sometimes tests first record an increase in hCG, and then its decrease. The woman does not feel any signs of pregnancy, and menstruation begins after a short (about a week) delay, and is often painful and more abundant than usual. This kind of pregnancy is called biochemical.

No matter how pregnancy occurs, after the fertilized egg attaches to the wall of the uterus, the production of hCG begins. The level of the hormone increases literally every day, allowing you to take a pregnancy test within a few days. Of course, it makes no sense to do it on the second day after IVF, since the amount of hCG in the blood or urine is still too small.

If on day 14 of DPP the hCG level shows below 5 mU/ml, this means that pregnancy has not occurred. A result of up to 25 mU/ml is considered questionable and requires additional verification.

A reading above 100 mU/mol indicates pregnancy.

Norms

HCG is detected in both urine and blood. Moreover, modern test strips are so sensitive that they detect even small amounts of the hormone, and digital tests can determine not only the presence of pregnancy, but also the period: 1–2, 2–3 or 3+.

As for hCG in the blood, in general it should be at a level corresponding to the table - minimum, average or maximum. For convenience, the table shows indicators for DPP - days elapsed after embryo transfer: 8, 9, 11, 15, 17, and so on. There are no values for days 3, 4 and up to 6 in the table.

But already from the 7th day the level of the hormone in the blood increases rapidly. If 45 mIU/ml is the maximum allowable reading on day 11, then if the HCN is 45 on day 12, this is already an average reading.

Moreover, even if the analysis indicates a value of 36–35 mU/ml, this is not a reason to panic. The main thing is that hCG is above normal and continues to rise.

On day 16, the average hCG value reaches 260 mU/ml, the minimum is 68, and the maximum is 400. By day 18, the indicators increase to 650, 220 and 840, respectively; by day 19, the average value increases to 980, the minimum to 370, the maximum – up to 1300 mU/mol.

Having a table at hand, the deciphered hCG value in the analysis will determine the gestational age. For example, 21 days after IVF the average reading will be 1960, but any result in the range from 960 to 3100 IU/ml will be normal; on day 22 the average is 2680, and the range will be from 1050 to 4900 IU/ml. The minimum value is 1440 mU/ml on day 23, and if blood was donated on day 26, then you should expect a reading from 4200 to 15600 mU/ml.

HCG level values of 55, 806, 3400, 605, 230, 1890, 600 can and should be interpreted only in relation to the number of days that have passed since the transfer; in themselves, they only mean an increased level of the hormone in the blood and, accordingly, the presence of pregnancy.

There are also tables of hCG levels by week. At a later date, it is much more convenient to check whether the level of hCG in the blood is normal.

But there are exceptions here too. In some women, the level of CHC in the blood increases slowly, preventing a reliable test result from being obtained. There may be several reasons for this. One of them is late implantation. The embryo does not have a clear schedule; modern science determines only approximate time periods during which fertilization should occur, the fertilized egg reaches the uterus, and the embryo is implanted into its wall.

It is also known that after IVF, implantation occurs later than with natural conception - approximately 10 days after the transfer. Accordingly, the hCG level rises more slowly, which means the test will show pregnancy a few days later. This must be taken into account when deciphering the analysis yourself.

In case of twins, tests, on the contrary, show hCG twice as high as the average values given in the table, since not one, but two embryos develop in the uterus. Based on this, the doctor can conclude that there is a multiple pregnancy. An exception is if the expectant mother has diabetes mellitus, severe toxicosis or gestosis, which can affect the analysis.

Reasons for slow growth

The main indicator of a developing pregnancy is the increase in hCG in the blood. However, its level is not so important. And even if the hormone level increases more slowly than in the tables, there is no reason to be upset. As the hormone level increases, the embryo also grows, even if the hCG is less than expected on a certain day after the transfer.

The reasons for slow growth may be the individual characteristics of the woman, previous or chronic diseases and other reasons, including insufficient function of the thyroid gland. Only a specialist can identify them.

If tests show a drop in hCG, this is an alarming signal that may indicate a missed abortion, spontaneous abortion, miscarriage, or ectopic pregnancy.

But even if hCG has dropped, this does not always mean that IVF was unsuccessful. The level of the hormone also drops with placental insufficiency or the threat of miscarriage - conditions that can be corrected with medication. If the analysis was carried out in the same clinic where IVF was performed, the attending physician will immediately prescribe so-called support - a set of drugs that support the embryo. In other cases, after receiving the test, you should immediately contact your doctor to receive timely help.

But women who are in a hurry to donate blood can also see a slow increase in the tests - in the first days the level of the hormone is low.

Feelings of increasing levels

As the embryo develops, hCG levels increase, and after some time the woman begins to feel certain signs of pregnancy, as with natural fertilization. Slight dizziness, drowsiness or morning sickness are symptoms that appear in some women during the normal course of pregnancy. A woman's body begins hormonal changes to bear a fetus.

There are no specific signs that the pregnancy was the result of IVF. From the moment the embryo is implanted, it is impossible to distinguish it from the natural one.

Some patients already in the first day after IVF say that they feel pregnant. But objectively, pregnancy has not yet occurred; the woman is simply subconsciously rushing things, hoping for a happy outcome. Doctors advise avoiding not only negative emotions during the waiting period, but also worry too much about the possible pregnancy. Instead, it is better to accustom yourself to daily measurements of general and basal temperature.

A decrease in the latter below 37C is a reason to consult a doctor, and an increase is normal after IVF.

Can analysis be wrong?

Sometimes, having received a blood test in hand, a woman checks the table and does not find the same result. The reason is that laboratories use different technologies and reagents, so specific analysis may differ from averages. Of course, laboratory assistants can make mistakes; no one is immune from this. But in laboratories with modern equipment, the human factor influences test results less and less. In such a situation, it is best to contact your doctor, who will either be able to interpret the results or refer you for analysis again.

Of course, the cause of a non-standard result may be the woman’s health status or various diseases. A low level of hCG, for example, may occur due to insufficient ovarian function, but the pregnancy develops normally.

Practice shows that there are enough women whose hCG does not fall within the norms prescribed in the tables, and many of them became mothers after successful IVF.

In case of any doubt, it is better to retake the test. Firstly, the hCG level is constantly growing and a later analysis will be more accurate. Secondly, this will help eliminate the small but existing possibility of error.

Possible problems

Although both the home test strip and the blood test performed in the laboratory are based on detecting elevated hCG, quite often their readings do not match. For example, with a negative test, the woman receives a positive test. This can also happen when, after IVF, a woman is waiting for confirmation of pregnancy. Barring incorrect use of the rapid test or the use of an expired test strip, then most likely the reason is that it is performed too early.

In urine, the level of hCG rises more slowly than in the blood, so manufacturers warn that the test is most accurate from a certain day of delay. If the test is taken 5-6 days after the transfer, it may not show pregnancy. We need to wait.

Taking diuretics may also affect the test result. or a large amount of liquid shortly before it is performed.

In some women, even during pregnancy, the hCG level rises slowly and the test does not show “two lines” at a longer period, when pregnancy has already been confirmed by ultrasound.

A blood test shows even a slight increase in hCG, so it should be trusted more.

Although hCG is called the pregnancy hormone, it is present in small concentrations in the blood of women not only during pregnancy and is detected even in men. An increase in hormone levels without pregnancy may indicate insufficient function of the kidneys or ovaries, as well as the thyroid gland, and in mature women, the onset of menopause.

There is a pregnancy

No pregnancy

Lifestyle after a positive result

In the first days after the transfer, the most important thing happens - its attachment to the wall of the uterus and the beginning of development. That's why these days it is better for a woman to avoid physical activity, active sports, and, if possible, stress. Sometimes it is advised to spend more time lying in bed, but research shows that a woman's position does not affect the development of the embryo.

If the test or blood test shows a positive result, this means that pregnancy has occurred. IN During this period, doctors recommend a measured lifestyle with leisurely walks and a healthy diet.. In the early stages, it is better to refrain from taking a hot bath, visiting saunas, or participating in sports competitions, and it is better to forget about heavy physical work until the end of pregnancy.

In addition to progesterone, estradiol drugs are prescribed, which has a positive effect on the endometrium, stimulates metabolic processes, and improves blood circulation in the uterus.

According to individual indications, the doctor may prescribe other drugs to maintain pregnancy: adrenal hormones, gonadotropins containing hCG. Your doctor may also recommend taking blood thinners and vitamins. This will help you endure a long-awaited pregnancy.

If, with a naturally occurring and normally occurring pregnancy, you can do without medications, then After IVF, it is better to listen to the recommendations of your doctor and take all prescribed medications.

Based on the tests, the doctor prescribes only the necessary medications, including hormonal ones, which complement the lack of substances necessary for the proper development of the child, which create optimal conditions for the course of pregnancy and reduce the likelihood of its termination.

Stories with happy endings

After IVF, a woman closely monitors her hCG levels. But if the test shows a low level of the hormone or it grows slowly, this does not always mean an unsuccessful attempt. In practice, there have already been many stories of successful pregnancies with low hCG.

For example, in one of the forum users, at 14 DPP, the analysis showed hCG only 21 mIU/ml, at 17 DPP – 81 mIU/ml, which is much lower than the average values. And only at 24 DPP the hCG value became three digits. But this did not stop the woman from carrying and giving birth to a healthy child.

Another woman had hCG at 14 DPP only 48 mU/ml, but by 29 DPP it had risen to 7000 mU/ml, which removed all questions about the prospects for pregnancy.

Another illustrative example. The woman’s test strip did not show pregnancy at all, although it was confirmed not only by an hCG test, but also by an ultrasound. By the way, the level of the hormone in the blood was very low. The story ended with the birth of a child.

The effectiveness of the in vitro fertilization procedure can be judged only 2 weeks after embryo transfer. To determine this, doctors perform an hCG test after IVF. Decoding the results of this study allows you to see whether pregnancy has occurred, track the condition of the fetus, the dynamics of its development, and helps prevent pathology.

The importance of hCG control during artificial insemination

The secretion of human chorionic gonadotropin in the female body increases after the embryo is fixed in the uterine wall. The hormone is produced by the fetal membrane, called the chorion. By the 12th week, it is transformed into the placenta, which supports the viability of the unborn baby until the end of the gestation period. HCG is also injected into the body of a woman wishing to become pregnant to stimulate ovulation. This method is used for both artificial and natural insemination.

Active growth of hCG after implantation is observed by the second week, so the test should be taken no earlier than 14 days after conception. The level of the hormone is monitored throughout the 9 months of bearing a child; with IVF, this control is especially important. This study allows you to determine the type of pregnancy: uterine or ectopic, multiple or not. In addition, IVF pregnancy is characterized by a very high probability of miscarriage, and monitoring gonadotropin levels makes it possible to prevent it.

Methods for determining hormone concentrations

Carrying out a test for gonadotropin during successful IVF is no different from testing during normal conception. The difference is that with natural fertilization, the test will be positive already 6–9 days after this, although it is usually carried out only after a delay in menstruation. During artificial insemination, the level of gonadotropin becomes indicative only two weeks after cryotransfer or insemination.

The simplest test option is to conduct a pregnancy test, which can be done at home. This method is convenient, but is not always reliable and often shows a false negative result. And such tests only check the presence of the hormone in the urine, and not the quantity.

A more accurate method is to find out the level of chorionic hormone in the bloodstream. To conduct the study, venous blood is taken from the patient.

It must be taken in the morning on an empty stomach. The result of such a study will determine not only the presence of gonadotropin, but also its level, which during artificial conception is of particular importance for maintaining pregnancy.

Dynamics of hCG growth during in vitro fertilization

The level of chorionic hormone in non-pregnant women is up to 5–7 IU/l (mIU/ml). It increases approximately 5 days after cryotransfer, but the dynamics of hormone release occurs rather slowly. Its concentration increases significantly after a week and a half. To get the most reliable result, doctors recommend repeat tests every 2-3 days.

By the concentration of gonadotropin you can determine:

whether the fertilized egg has implanted;
number of embryos (one or several);
frozen pregnancy;
fetal pathologies.

A table of hCG values after transfer of three-day and five-day embryos by day will help you evaluate the success of IVF and the course of pregnancy.

Table of hCG and its level by day after embryo transfer

Embryo age (number of days after puncture)	DPP of a three-day embryo	DPP of a five-day fetus	Least gonadotropin indicator	Average value	Highest indicator
7	4	2	2	4	10
8	5	3	3	8	18
9	6	4	3	9	18
10	7	5	8	18	26
11	8	6	11	28	45
12	9	7	17	45	65
13	10	8	22	73	105
14	11	9	30	105	770
15	12	10	39	160	270
16	13	11	68	260	400
17	14	12	120	410	580
18	15	13	220	650	840

The hCG level begins to increase rapidly at 10–14 DPP. For example, the minimum hCG value at 13 DPP is already 22, the maximum is 105. By day 36, the highest value already reaches 78,000, by 42 – more than 120 thousand.

Gonadotropin during multiple pregnancy

To increase the chances of successful IVF, several embryos are transferred, so a woman often gives birth to twins after artificial insemination. Doctors may also suggest preserving and freezing unused embryos in case the attempt fails. With a cryoprotocol, a repeat IVF cycle can be completed faster.

Table HCG level in multiple IVF pregnancies by week

Embryonic week period	Gonadotropin level
1-2	50-600
2-3	3000–10000
3-4	20000–60000
4-5	40000–2000000
5-6	100000–400000
6-7	100000–400000
7-8	40000–400000
8-10	40000–200000

Starting from week 10, the figure reaches 400,000 and increases rapidly, then a slowdown in growth occurs. If a sharp jump is detected, both in the direction of decrease and increase, the doctor prescribes additional studies to eliminate the risks of pathologies of fetal development.

Reasons for hormone reduction during IVF

First of all, a decrease in hCG indicates that fertilization has not occurred. This also occurs with an ectopic pregnancy or implantation bleeding. A low level of the hormone may be a sign that the child’s development has stopped, or that intrauterine death has occurred. A similar situation is also observed with a possible threat of miscarriage. Its first signs are a decrease in chorionic hormone by 50% of normal and an increase in body temperature. Symptoms include pain in the lumbar region, the presence of bloody discharge as during menstruation.

In addition, a low level of gonadotropin can be observed in normal but late pregnancy. This is not a cause for concern, since in this case the embryo develops normally. In any case, if the value is underestimated, the patient is sent for a repeat analysis to check whether the result is erroneous. Sometimes the doctor performs additional diagnostics - ultrasound.

Reasons for increased hCG after implantation

It is worth noting that excess gonadotropin secretion is not uncommon. This is usually explained by the fact that during IVF several embryos are implanted, and two survive. If multiple pregnancy is not confirmed, then the reason for the increase in hCG is sought in the woman’s health. High levels of the hormone can be observed during gestosis. It will also grow while taking synthetic gestagens. If gonadotropin is exceeded many times in the second trimester of pregnancy, this indicates possible pathologies in the development of the fetus. Sometimes the cause of growth is the early use of drugs containing gonadotropin.

The calculator will help you decipher the results of a blood test for hCG by day after IVF (embryo transfer) and evaluate the dynamics of the growth of the hormone level.

HCG doubling period in singleton pregnancy

HCG begins to be produced already 6-10 days after fertilization of the egg. In the first weeks, your hCG levels should double approximately every 2 days. As the gestational age increases, the rate of its growth slows down - when the level reaches 1200 mU/ml, hCG doubles every 3-4 days (from 72 to 96 hours), and after 6000 mU/ml the doubling occurs on average every 4 days (96 hours).

PM - according to the date of the last menstruation.
DPP - days after puncture.

The concentration of hCG reaches its maximum at 9-11 weeks of pregnancy, then the level of hCG begins to slowly decrease.

During multiple pregnancies, the hCG content increases in proportion to the number of fetuses, and on average, hCG levels in pregnant women with twins (triplets) are usually higher than in other pregnant women at the same stage.

Laboratory standards and user results

HCG standards may vary in different laboratories. This is due to the use of various research techniques, reagents and other factors. Therefore, to correctly assess the dynamics of hormone growth, it is necessary to conduct research in one laboratory and evaluate the results relative to the standards of this laboratory. The hCG calculator allows you to evaluate your results relative to the standards of different laboratories:

The results of other users on the graph may also differ (depending on laboratory standards) and contain errors (for example, data was entered incorrectly).

In vitro fertilization allows you to cope with most factors of infertility. There are various protocols by which this technology is implemented. In some cases, IVF is carried out in a natural cycle, in others - with the preliminary administration of stabilizing and stimulating hormonal drugs. If the result of the procedure is positive, the long-awaited pregnancy occurs. As a control test on days 10-14 after embryo transfer, an analysis for human chorionic gonadotropin is used. What does the hCG level look like after embryo transfer?

What is hCG?

Human chorionic gonadotropin is called the “pregnancy hormone”. It can be produced by the body of a woman who is in childbearing age after the moment of conception. It is synthesized by the fertilized egg. After moving along the fallopian tube into the uterine cavity, it begins to implant into the endometrium. This is how the trophoblast is formed - the outer layer of embryonic cells, from which the placenta will later be formed. It is during the formation of this structure of the fetal egg that hCG is produced. Simply put, in the absence of pathologies in the reproductive or endocrine system, such a hormone can be produced exclusively during pregnancy.

Pregnancy hormone - what is it?

When assessing the fact of conception, an analysis is taken for a special beta-type hormonal subunit (HCGb), while the universal abbreviation hCG is used in mass use. Decoding the results of such testing is always carried out dynamically. The fact is that each woman has her own body characteristics, which means that human chorionic gonadotropin can be produced in different ways. This approach makes it possible to ensure that the pregnancy is progressing correctly and that there are no threats to the embryo or any other problems.

HCG during IVF is fundamentally important for the normal development of the baby. Thanks to him:

at the initial stages, the production of progesterones and estrogens is stimulated, affecting the trophoblast and necessary for implantation and normal development of the embryo;
the disappearance or premature depletion of the corpus luteum, a temporary gland that nourishes the uterus and fetus until the formation of the placenta, is prevented;
suppresses the “aggressive” immunity of the mother, which can provoke detachment of the ovum or fading of pregnancy;
a start is given to physiological changes in the body of the expectant mother;
ensures sexual differentiation of male children;
has a direct effect on the gonads and adrenal glands of the fetus.

In other words, it is due to hCG during IVF that pregnancy develops: this hormone literally “tunes” the woman’s body for the successful bearing of a child and helps the fetus grow correctly.

An hCG test after IVF is needed to monitor pregnancy

How does the hCG level change by day after implantation?

HCG during IVF can be detected in the blood plasma already 9-10 days after ovulation. In addition, human chorionic gonadotropin is excreted only by the kidneys; it is on the basis of this feature that pharmacy test strips of all types work. However, you need to understand that to assess the results of in vitro fertilization, simply a positive reaction to the hormone is not enough; control of its growth is necessary. If its presence has been detected even in a minimal concentration, monitoring over time is necessary. Normally, hCG levels after embryo transfer and successful implantation of at least one embryo should double every 48 hours.

As in the case of natural conception, hCG levels after IVF change according to a certain pattern. Its concentration begins to increase after the egg penetrates the endometrium. The first results can be assessed 10-14 days from the moment of conception. The peak level of human chorionic gonadotropin normally occurs at 8-10 obstetric weeks of pregnancy. Before this period, the level of the hormone in the blood increases, and after that it begins to gradually decrease. The decline in hCG concentration ends at approximately 20-21 weeks, after which the levels remain stable throughout pregnancy. Its sharp decrease in recent months is one of the symptoms of placental aging, which is dangerous for the development of the baby.

HCG norms after IVF - what do they depend on?

There are special hCG tables for days after IVF. They allow you to roughly assess how the pregnancy is developing. Nevertheless, the interpretation of any analysis must be carried out by a doctor, because only he is able to assess the dynamics taking into account the health status of a particular patient. All information in such tables is for reference only, as do not take into account the individual characteristics of the expectant mother’s body. In addition, it is necessary to separately consider cases when, after transfer, 2 or 3 embryos take root and a multiple pregnancy occurs.

HCG table after embryo transfer by day

When performing in vitro fertilization, embryos fertilized in vitro mature in an embryological laboratory within 3-5 days. After this, they are implanted back into the woman’s body, placing them in the uterus using a special thin catheter. In the tables with hCG norms after IVF, the assessment is carried out by DPP - by days after the transfer. This takes into account not only the exact period from the “zero” day of egg puncture, but also the “age” of the embryo that was selected for transfer.

Table of hCG growth by days after conception “age” of the embryo that was selected for transfer.

The table of hCG indicators after IVF shows the norms by day. To more accurately assess the result, you need to start from how many days the invitro-fertilized embryo was at the time of transplantation into the uterus - 3 or 5. In the last three columns there are 3 options: minimum, maximum and average. Deviations from the norm can be caused by various factors. An insufficiently high level of human chorionic gonadotropin, as well as a false-positive strip test, can signal a dangerous ectopic implantation of the embryo; an overestimated level is a sign of a multiple pregnancy. For example, in the case of twins, already during the first test after IVF, you can see a hCG level of up to 400 mU/ml, i.e. 3 times higher than normal. Low hCG levels may be due to failed implantation or because the test was done too early. But other options are also possible, including those associated with pathological processes. That is why a doctor should assess the level and dynamics of hCG growth after embryo transfer.