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USA hCG reference service, 10-year report.

Laurence A Cole¹, Laura L Laidler, Carolyn Y Muller

¹USA hCG Reference Service, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87109, USA. larry@hcglab.com

Clinical Biochemistry

|May 25, 2010

Summary

The USA hCG Reference Service identified 565 cases of hCG-related disorders, including gestational trophoblastic disease and false positives. New diagnostic methods were developed and tested for these conditions.

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Area of Science:

Reproductive Endocrinology
Clinical Chemistry

Background:

The USA hCG Reference Service has a decade of experience managing persistent low human chorionic gonadotropin (hCG) levels and gestational trophoblastic diseases (GTD).
This study presents a comprehensive review of their extensive case experience.

Purpose of the Study:

To report on the diverse range of hCG-related disorders encountered by the USA hCG Reference Service.
To introduce and evaluate novel diagnostic methodologies for these conditions.

Main Methods:

Total hCG was quantified in serum and urine using the Siemens Immulite 1000 assay.
Specific hCG variants (hyperglycosylated hCG, nicked hCG, free β-subunit, β-core fragment) were measured via microtiterplate assays utilizing specific antibodies.

Main Results:

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The service identified 565 cases, including 83 false-positive hCG results, various forms of GTD (71 aggressive, 52 minimally invasive, 168 quiescent), placenta site trophoblastic tumor (22 cases), pituitary hCG (103 cases), nontrophoblastic tumors (60 cases), inherited hCG (4 cases), and Munchausen's syndrome (2 cases).
New diagnostic methods were developed and validated for these diverse hCG-related disorders.

Conclusions:

The USA hCG Reference Service's experience highlights the complexity of hCG-related disorders.
The study recommends novel approaches for the accurate detection and diagnosis of these conditions.