Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-lrblm Total loading time: 0 Render date: 2025-01-07T22:46:12.530Z Has data issue: false hasContentIssue false

Chapter 4 - The Role of Human Chorionic Gonadotropin in Pregnancy

from Section I - Hormones in the Physiology and Pharmacology of Pregnancy

Published online by Cambridge University Press:  09 November 2022

By
Keiichi Kumasawa  and
Yutaka Osuga
Edited by
Felice Petraglia ,
Mariarosaria Di Tommaso  and
Federico Mecacci
Felice Petraglia
Affiliation:
Università degli Studi, Florence
Mariarosaria Di Tommaso
Affiliation:
Università degli Studi, Florence
Federico Mecacci
Affiliation:
Università degli Studi, Florence
Get access

Summary

Human chorionic gonadotropin (hCG) is primarily produced in human trophoblasts and placentas. It comprises α- and β-subunits, the former of which is a common form of gonadotropins, and the latter is typical of hCG. hCG has three main functions: corpus luteum maintenance, testicular stimulation, and maternal thyroid stimulation. hCG is used to determine pregnancy, with commercial urine hCG pregnancy kits widely used. In addition, hCG is used to judge normal pregnancy. One typical case of abnormal pregnancy is ectopic pregnancy, and the other is gestational trophoblastic disease. The β-subunit is useful for determining both normal pregnancy and gestational trophoblastic disease.

Type
Chapter
Information
Hormones and Pregnancy
Basic Science and Clinical Implications
 , pp. 33 - 41
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pierce, JG, and Parsons, TF. Glycoprotein hormones: Structure and function. Annu Rev Biochem. 1981, 50: 465–495.Google Scholar
Stockell Hartree, A, and Renwick, AG. Molecular structures of glycoprotein hormones and functions of their carbohydrate components. Biochem J. 1992, 287(Pt 3): 665–679.Google Scholar
Godine, JE, Chin, WW, and Habener, JF. Alpha Subunit of rat pituitary glycoprotein hormones. Primary structure of the precursor determined from the nucleotide sequence of cloned cDNAs. J Biol Chem. 1982, 257, 8368–8371,Google Scholar
Golos, TG, Durning, M, and Fisher, JM. Molecular cloning of the rhesus glycoprotein hormone alpha-subunit gene. DNA Cell Biol. 1991, 10, 367–380.Google Scholar
McGregor, WG, Kuhn, RW, and Jaffe, RB. Biologically active chorionic gonadotropin: Synthesis by the human fetus. Science. 1983, 220, 306–308.Google Scholar
Miller-Lindholm, AK, LaBenz, CJ, Ramey, J, et al. Human chorionic gonadotropin-beta gene expression in first trimester placenta. Endocrinology. 1997, 138, 5459–5465.Google Scholar
Morrish, DW, Manickavel, V, Jewell, LD, et al. Immunolocalization of alpha and beta chains of human chorionic gonadotropin, placental lactogen and pregnancy-specific beta-glycoprotein in term placenta by a touch preparation method. Histochemistry. 1987, 88, 57–60.Google Scholar
Hoshina, M, Ashitake, Y, and Tojo, S. Immunohistochemical interaction on antisera to HCG and its subunits with chorionic tissue of early gestation. Endocrinol Jpn. 1979, 26, 175–184.CrossRefGoogle ScholarPubMed
Maruo, T, Ladines-Llave, CA, Matsuo, H, et al. A novel change in cytologic localization of human chorionic gonadotropin and human placental lactogen in first-trimester placenta in the course of gestation. Am J Obstet Gynecol. 1992, 167, 217–222.CrossRefGoogle ScholarPubMed
Beck, T, Schweikhart, G, and Stolz, E. Immunohistochemical location of HPL, SP1 and beta-HCG in normal placentas of varying gestational age. Arch Gynecol. 1986, 239, 63–74.Google Scholar
Hoshina, M, Boothby, M, and Boime, I. Cytological localization of chorionic gonadotropin alpha and placental lactogen mRNAs during development of the human placenta. J Cell Biol. 1982, 93, 190–198Google Scholar
Cole, LA. Immunoassay of human chorionic gonadotropin, its free subunits, and metabolites. Clin Chem. 1997, 43, 2233–2243.Google Scholar
Wolfahrt, S, Kleine, B, and Rossmanith, WG. Detection of gonadotrophin releasing hormone and its receptor mRNA in human placental trophoblasts using in-situ reverse transcription-polymerase chain reaction. Mol Hum Reprod. 1998, 4, 999–1006.Google Scholar
Petraglia, F, Vaughan, J, and Vale, W. Inhibin and activin modulate the release of gonadotropin-releasing hormone, human chorionic gonadotropin, and progesterone from cultured human placental cells. Proc Natl Acad Sci USA. 1989, 86, 5114–5117.Google Scholar
Wehmann, RE, and Nisula, BC. Renal clearance rates of the subunits of human chorionic gonadotropin in man. J Clin Endocrinol Metab. 1980, 50, 674–679.Google Scholar
Zirkin, BR, and Papadopoulos, V. Leydig cells: Formation, function, and regulation. Biol Reprod. 2018, 99, 101–111.Google Scholar
Clements, JA, Reyes, FI, Winter, JS, et al. Studies on human sexual development. III. Fetal pituitary and serum, and amniotic fluid concentrations of LH, CG, and FSH. J Clin Endocrinol Metab. 1976, 42, 9–19.CrossRefGoogle ScholarPubMed
Molsberry, RL, Carr, BR, Mendelson, CR, et al. Human chorionic gonadotropin binding to human fetal testes as a function of gestational age. J Clin Endocrinol Metab. 1982, 55, 791–794.Google Scholar
Tapanainen, J, Kellokumpu-Lehtinen, P, Pelliniemi, L, et al. Age-related changes in endogenous steroids of human fetal testis during early and midpregnancy. J Clin Endocrinol Metab. 1981, 52, 98–102.CrossRefGoogle ScholarPubMed
Leinonen, PJ, and Jaffe, RB. Leydig cell desensitization by human chorionic gonadotropin does not occur in the human fetal testis. J Clin Endocrinol Metab. 1985, 61, 234–238.Google Scholar
Hershman, JM. Human chorionic gonadotropin and the thyroid: Hyperemesis gravidarum and trophoblastic tumors. Thyroid. 1999, 9, 653–657.Google Scholar
Kraiem, Z, Sadeh, O, Blithe, DL, et al. Human chorionic gonadotropin stimulates thyroid hormone secretion, iodide uptake, organification, and adenosine 3’,5’-monophosphate formation in cultured human thyrocytes. J Clin Endocrinol Metab. 1994, 79, 595–599.Google Scholar
Tomer, Y, Huber, GK, and Davies, TF. Human chorionic gonadotropin (hCG) interacts directly with recombinant human TSH receptors. J Clin Endocrinol Metab. 1992, 74, 1477–1479.Google Scholar
Fitzpatrick, DL, and Russell, MA. Diagnosis and management of thyroid disease in pregnancy. Obstet Gynecol Clin North Am. 2010, 37, 173–193.Google Scholar
Nathan, N, and Sullivan, SD. Thyroid disorders during pregnancy. Endocrinol Metab Clin North Am. 2014, 43, 573–597.Google Scholar
Oppenheimer, JH, and Schwartz, HL. Molecular basis of thyroid hormone-dependent brain development. Endocr Rev, 1997, 18, 462–475.Google ScholarPubMed
Noten, AM, Loomans, EM, Vrijkotte, TG, et al. Maternal hypothyroxinaemia in early pregnancy and school performance in 5-year-old offspring. Eur J Endocrinol. 2015, 173, 563–571.Google Scholar
Nelson, SM, Haig, C, McConnachie, A, et al. Maternal thyroid function and child educational attainment: Prospective cohort study. BMJ. 2018, 360, k452.Google Scholar
Remaud, S, Gothie, JD, Morvan-Dubois, G, et al. Thyroid hormone signaling and adult neurogenesis in mammals. Front Endocrinol (Lausanne). 2014, 5, 62.Google Scholar
Kurtzman, JT, Wilson, H, and Rao, CV. A proposed role for hCG in clinical obstetrics. Semin Reprod Med. 2001, 19, 63–68.Google Scholar
Kane, N, Kelly, R, Saunders, PT, et al. Proliferation of uterine natural killer cells is induced by human chorionic gonadotropin and mediated via the mannose receptor. Endocrinology. 2009, 150, 2882–2888.Google Scholar
Han, T. Inhibitory effect of human chorionic gonadotrophin on lymphocyte blastogenic response to mitogen, antigen and allogeneic cells. Clin Exp Immunol. 1974, 18, 529–535.Google Scholar
Braunstein, GD. The long gestation of the modern home pregnancy test. Clin Chem. 2014, 60, 18–21.Google Scholar
Wilcox, AJ, Baird, DD, Dunson, D, et al. Natural limits of pregnancy testing in relation to the expected menstrual period. JAMA. 2001, 286, 1759–1761.CrossRefGoogle Scholar
Braunstein, GD. False-positive serum human chorionic gonadotropin results: Causes, characteristics, and recognition. Am J Obstet Gynecol. 2002, 187, 217–224.Google Scholar
Montagnana, M, Trenti, T, Aloe, R, et al. Human chorionic gonadotropin in pregnancy diagnostics. Clin Chim Acta. 2011, 412, 1515–1520.Google Scholar
Grenache, DG. Variable accuracy of home pregnancy tests: Truth in advertising? Clin Chem Lab Med. 2015, 53, 339–341.Google Scholar
Johnson, S, Cushion, M, Bond, S, et al. Comparison of analytical sensitivity and women’s interpretation of home pregnancy tests. Clin Chem Lab Med. 2015, 53, 391–402.CrossRefGoogle ScholarPubMed
Cole, LA. The utility of six over-the-counter (home) pregnancy tests. Clin Chem Lab Med. 2011, 49, 1317–1322.Google Scholar
Banerjee, S, Smallwood, A, Chambers, AE, et al. A link between high serum levels of human chorionic gonadotrophin and chorionic expression of its mature functional receptor (LHCGR) in Down’s syndrome pregnancies. Reprod Biol Endocrinol. 2005, 3, 25.Google Scholar
Stenman, UH, Alfthan, H, and Hotakainen, K. Human chorionic gonadotropin in cancer. Clin Biochem. 2004, 37, 549–561.Google Scholar
Bedi, DG, Moeller, D, Fagan, CJ, et al. Chronic ectopic pregnancy. A comparison with acute ectopic pregnancy. Eur J Radiol. 1987, 7, 46–48.Google Scholar
Brennan, DF, Kwatra, S, Kelly, M, et al. Chronic ectopic pregnancy – Two cases of acute rupture despite negative beta hCG. J Emerg Med. 2000, 19, 249–254.Google Scholar
Smith, HO, Kohorn, E, and Cole, LA. Choriocarcinoma and gestational trophoblastic disease. Obstet Gynecol Clin North Am. 2005, 32, 661–684.Google Scholar
Barnhart, K, Mennuti, MT, Benjamin, I, et al. Prompt diagnosis of ectopic pregnancy in an emergency department setting. Obstet Gynecol. 1994, 84, 1010–1015.Google Scholar
Barnhart, K, Sammel, MD, Chung, K, et al. Decline of serum human chorionic gonadotropin and spontaneous complete abortion: Defining the normal curve. Obstet Gynecol. 2004, 104, 975–981.Google Scholar
Seeber, BE, Sammel, MD, Guo, W, et al. Application of redefined human chorionic gonadotropin curves for the diagnosis of women at risk for ectopic pregnancy. Fertil Steril. 2006, 86, 454–459.Google Scholar
Chung, K, Sammel, MD, Coutifaris, C, et al. Defining the rise of serum HCG in viable pregnancies achieved through use of IVF. Hum Reprod. 2006, 21, 823–828.Google Scholar
Silva, C, Sammel, MD, Zhou, L, et al. Human chorionic gonadotropin profile for women with ectopic pregnancy. Obstet Gynecol. 2006, 107, 605–610.Google Scholar
Zee, J, Sammel, MD, Chung, K, et al. Ectopic pregnancy prediction in women with a pregnancy of unknown location: Data beyond 48 h are necessary. Hum Reprod. 2014, 29, 441–447.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×