Human Chorionic Gonadotropin

Meaning

Human Chorionic Gonadotropin, hCG, is a glycoprotein hormone produced by syncytiotrophoblast cells of the placenta after implantation. Its primary role is to sustain the corpus luteum, an ovarian structure crucial for progesterone production. This progesterone maintains the uterine lining, preventing menstruation and supporting early pregnancy.

Context

Within the human endocrine system, hCG functions as a vital signaling molecule during early gestation. It mimics luteinizing hormone (LH), ensuring the corpus luteum’s continued viability and steroidogenic activity. Progesterone secretion is vital for endometrial receptivity and conceptus maintenance. Abnormal cellular proliferations, like germ cell tumors, can also produce hCG.

Significance

Clinically, hCG is vital in reproductive health and oncology. Its presence in blood or urine forms the basis for pregnancy tests, providing an early indicator of conception. Monitoring hCG levels assists in assessing gestational viability, diagnosing ectopic pregnancies, and evaluating trophoblastic diseases. Elevated hCG indicates germ cell tumors, valuable for diagnosis and treatment.

Mechanism

The biological action of hCG is mediated through its binding to the LHCG-R, a G protein-coupled receptor on corpus luteum cells. This binding activates adenylate cyclase, increasing intracellular cyclic AMP. The resulting cascade stimulates progesterone and estrogen synthesis, preventing luteolysis and maintaining the endometrium.

Application

Clinically, hCG is utilized in diagnostic and therapeutic protocols. Urine or serum hCG assays confirm pregnancy. In assisted reproductive technologies, exogenous hCG administration triggers oocyte maturation and ovulation. For men with hypogonadotropic hypogonadism, hCG stimulates Leydig cells to produce testosterone. Serial hCG measurements track germ cell tumors and gestational trophoblastic neoplasia.

Metric

Quantitative measurement of hCG is achieved through immunoassay techniques on serum or urine samples. Serum beta-hCG assays provide precise numerical values for assessing gestational age and pregnancy progression. Urine pregnancy tests qualitatively detect hCG presence above a threshold. In oncology, serum hCG levels are routinely measured as a tumor marker, with trends guiding treatment decisions.

Risk

While generally safe under medical supervision, hCG therapy carries potential risks. In women undergoing fertility treatments, ovarian hyperstimulation syndrome (OHSS) is a significant concern, characterized by ovarian enlargement and fluid shifts. hCG use for unproven weight loss is not supported and poses risks. Administration can lead to multiple gestations. Allergic reactions and injection site reactions are possible adverse events.

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