Beta-hCG (total + beta subunit)

Blood beta HCG measures human chorionic gonadotropin (hCG), a hormone produced by cells of the developing placenta from the early days of pregnancy. It is most often used as a blood pregnancy test and for monitoring early pregnancy, and doctors also use it as a tumour marker for certain testicular, ovarian and placental tumours.

Who is this test for

• women who suspect pregnancy when a home test is unclear or they need an exact measurement;
• pregnant women with bleeding or pain in early pregnancy;
• women with a previous miscarriage or who conceived through assisted reproduction, for early pregnancy monitoring;
• women after miscarriage or treatment of an ectopic pregnancy, until hCG falls to a non-pregnant level;
• people with a testicular or ovarian germ cell tumour or trophoblastic disease, for specialist-led diagnosis and treatment monitoring.

What hCG is and what it shows

After the fertilised egg implants in the uterus, hCG enters the mother’s blood and rises rapidly in early pregnancy. The test measures total hCG together with the free beta subunit and gives an exact numerical value, rather than simply a positive or negative result. It is expressed in IU/L, equivalent to mIU/mL. In non-pregnant women and men, hCG is very low.

As a tumour marker, hCG is measured in testicular and ovarian germ cell tumours alongside AFP and LDH, and in trophoblastic disease (hydatidiform mole, choriocarcinoma).

Preparation and sample

A venous blood sample is collected. Fasting is unnecessary and the time of day does not matter. A blood pregnancy test may become positive several days before a home urine test, but if performed too early it may be negative despite pregnancy. It is most reliable from the day the period was due.

Mention at collection if you received an hCG injection as part of fertility treatment, because this may produce a positive result without pregnancy. If you take biotin (for example, hair and nail supplements), mention this when your blood is drawn. When hCG is monitored over several days, it is best to use the same laboratory.

How results are interpreted

Thresholds depend on the method and are printed on the report. As a guide:

• below 5 IU/L: the result is negative;
• 5 to 25 IU/L: the result is unclear and the test is repeated after two to three days;
• above 25 IU/L: the result usually indicates pregnancy.

Around and after menopause, hCG may be slightly elevated without pregnancy, because the pituitary gland produces small amounts. Laboratories therefore state a slightly higher upper limit for these women.

hCG values by week of pregnancy

Week from the first day of the last period	Approximate hCG range (IU/L)
3.	5–50
4.	5–426
5.	18–7.340
6.	1.080–56.500
7.–8.	7.650–229.000
9.–12.	25.700–288.000
13.–16.	13.300–254.000
17.–24.	4.060–165.400
25.–40.	3.640–117.000

Ranges are approximate and method-dependent, so use the limits accompanying your result. They are very wide and overlap, so one value cannot establish the pregnancy week or show whether pregnancy is developing normally. hCG peaks around weeks 8 to 11 and then falls. A gynaecologist establishes pregnancy duration and location with ultrasound.

hCG rise in early pregnancy

Until approximately week 6, hCG usually rises rapidly and often doubles in two to three days, then rises more slowly. A slower rise does not necessarily indicate a problem, while a normal rise does not rule out ectopic pregnancy. The gynaecologist therefore compares two measurements taken 48 hours apart and interprets them with ultrasound.

Contact emergency services immediately if, with a positive test or missed period, you have severe lower abdominal pain, particularly on one side, vaginal bleeding, shoulder-tip pain, dizziness or fainting. These may be signs of ectopic pregnancy, a medical emergency, so do not wait for an hCG result.

hCG outside pregnancy

Elevated hCG in a man or non-pregnant woman requires medical investigation. In testicular tumours, high values indicate a non-seminomatous tumour, while some people with seminoma may have mildly elevated hCG. After successful treatment hCG falls, and a renewed rise may indicate recurrence. Rarely, certain blood antibodies falsely elevate the result, so the doctor checks a result inconsistent with the clinical picture using another method. Read more about markers in the article Tumour markers.

How to arrange testing

You can come for blood collection without an appointment or referral at one of our branches throughout Croatia (listed on the Contactpage). Prices for all tests and panels are listed in the service price list.

Frequently asked questions

Is a blood pregnancy test more reliable than a urine test?

The blood test is more sensitive and shows the exact hCG amount, so it can detect pregnancy slightly earlier and monitor its development. A home urine test after a missed period is reliable for most women but does not show hormone levels.

What beta HCG is normal in week 4 or 5?

In week 4 from the last period, values are most often between 5 and 426 IU/L, and in week 5 between 18 and 7.340 IU/L. Differences between women are large, so the rise over several days matters more than one value.

What does beta HCG below 5 mean?

The result is negative. If testing was too early and your period is still absent, repeat it after several days or contact your gynaecologist.

Can hCG remain elevated after miscarriage?

Yes. After miscarriage or childbirth, hCG falls gradually and may remain measurable for several weeks. If necessary, the gynaecologist monitors it until it falls below the pregnancy threshold.