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Why is HCG elevated without pregnancy, and what should be done?

Nov 14, 2024 Source: Cainiu Health
Dr. Zhang Lu
Introduction
In general, elevated HCG levels without pregnancy may be caused by factors such as the ovulation period, use of ovulation-inducing medications, hydatidiform mole, gestational choriocarcinoma, or malignant tumors, and management should vary depending on the specific situation. If HCG levels are elevated but pregnancy is not present, a comprehensive gynecological ultrasound should be performed to check for any abnormal masses in the uterus and adnexa, enabling the physician to comprehensively assess the underlying cause and formulate an accurate treatment plan.

HCG refers to human chorionic gonadotropin. Generally, elevated levels of human chorionic gonadotropin without pregnancy may be caused by factors such as the ovulation period, use of ovulation-stimulating medications, hydatidiform mole, gestational choriocarcinoma, or malignant tumors, and management should be based on the specific situation.

1. Ovulation period: During a woman's ovulation period, there is a peak in luteinizing hormone (LH). Since LH and human chorionic gonadotropin (hCG) have certain structural similarities, cross-reaction may occur, leading to test results indicating elevated hCG levels. Usually, no special treatment is required, and hormone levels will return to normal after ovulation.

2. Use of ovulation-stimulating medications: Ovulation-stimulating drugs may affect ovarian function and disrupt the body's hormonal balance, leading to increased secretion of substances similar to human chorionic gonadotropin during the ovulation process. It is recommended to closely monitor under a physician's guidance and continue follicular monitoring according to the treatment plan.

3. Hydatidiform mole: A hydatidiform mole occurs due to abnormal development of the fertilized egg, with excessive proliferation of placental villous trophoblast cells. These abnormally proliferating trophoblast cells secrete large amounts of human chorionic gonadotropin, causing significantly elevated hCG levels. Immediate ultrasound examination is recommended to confirm the diagnosis, followed by treatment such as dilation and curettage (D&C) or hysterectomy under medical guidance.

4. Gestational choriocarcinoma: Gestational choriocarcinoma usually develops after a hydatidiform mole, miscarriage, or full-term delivery. It is a highly malignant tumor, and the trophoblastic cells continuously secrete large amounts of human chorionic gonadotropin, resulting in persistently high hCG levels. Treatment options such as chemotherapy or radiotherapy are recommended under medical supervision.

5. Malignant tumors: Certain malignant tumors such as gastric cancer, liver cancer, and pancreatic cancer may involve tumor cell dedifferentiation, acquiring the ability to secrete human chorionic gonadotropin, thereby increasing hCG levels in the blood. It is recommended to develop a comprehensive treatment plan based on the specific tumor condition, including surgery, chemotherapy, radiation therapy, etc., under a physician's guidance.

If human chorionic gonadotropin levels are elevated but pregnancy is not present, a comprehensive gynecological ultrasound is recommended to examine the uterus and adnexa for any abnormal masses, allowing physicians to make an integrated assessment of the underlying cause and formulate an accurate treatment plan.

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