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Human chorionic gonadotropin (American English) or Human chorionic
gonadotrophin (hCG) is a glycoprotein hormone produced in pregnancy
that is made by the developing embryo soon after conception and
later by the syncytiotrophoblast (part of the placenta).
Its role is to prevent the disintegration of the corpus luteum of
the ovary and thereby maintain progesterone production that is
critical for a pregnancy in humans. hCG may have additional
functions; for instance, it is thought that hCG affects the immune
tolerance of the pregnancy. Early pregnancy testing, in general, is
based on the detection or measurement of hCG. Because hCG is
produced also by some kinds of tumor, hCG is an important tumor
marker, but it is not known whether this production is a
contributing cause or an effect of tumorigenesis.
Human chorionic gonadotropin interacts with the LHCG receptor and
promotes the maintenance of the corpus luteum during the beginning
of pregnancy, causing it to secrete the hormone progesterone.
Progesterone enriches the uterus with a thick lining of blood
vessels and capillaries so that it can sustain the growing fetus.
Due to its highly-negative charge, hCG may repel the immune cells
of the mother, protecting the fetus during the first trimester. It
has also been hypothesized that hCG may be a placental link for the
development of local maternal immunotolerance. For example,
hCG-treated endometrial cells induce an increase in T cell
apoptosis (dissolution of T-cells).
These results suggest that hCG may be a link in the development of
peritrophoblastic immune tolerance, and may facilitate the
trophoblast invasion, which is known to expedite fetal development
in the endometrium. It has also been suggested that hCG levels are
linked to the severity of morning sickness in pregnant women.
Because of its similarity to LH, hCG can also be used clinically to
induce ovulation in the ovaries as well as testosterone production
in the testes. As the most abundant biological source is women who
are presently pregnant, some organizations collect urine from
pregnant women to extract hCG for use in fertility treatment.
Human chorionic gonadotropin also plays a role in cellular
differentiation/proliferation and may activate apoptosis.
Main article: tumor marker
The β subunit of human chorionic gonadotropin is secreted also by
some cancers including choriocarcinoma, germ cell tumors,
hydatidiform mole formation, teratoma with elements of
choriocarcinoma (this is rare), and islet cell tumor. For this
reason a positive result in males can be a test for testicular
cancer. The normal range for men is between 0-5 IU/ml.
Human chorionic gonadotropin is extensively used as a parenteral
fertility medication in lieu of luteinizing hormone. In the
presence of one or more mature ovarian follicles, ovulation can be
triggered by the administration of hCG. As ovulation will happen
about 36–48 hours after the injection of hCG, procedures can be
scheduled to take advantage of this time sequence. Thus, patients
that undergo IVF, in general, receive hCG to trigger the ovulation
process, but have their eggs retrieved at about 36 hours after
injection, a few hours before the eggs actually would be released
from the ovary.
As hCG supports the corpus luteum, administration of hCG is used in
certain circumstances to enhance the production of progesterone.
In the male, hCG injections are used to stimulate the leydig cells
to synthesize testosterone. The intratesticular testosterone is
necessary for spermatogenesis from the sertoli cells. Typical uses
for hCG in men include hypogonadism and fertility treatment.
During first few months of pregnancy, the transmission of HIV-1
from woman to fetus is extremely rare. It has been suggested that
this is due to the high concentration of hCG, and that the
beta-subunit of this protein is active against HIV-1.
A controversial usage of hCG is as an adjunct to the British
endocrinologist A.T.W. Simeons' ultra-low-calorie weight-loss diet.
Simeons, while studying pregnant women in India on a
calorie-deficient diet, and “fat boys” with pituitary problems
treated with low-dose hCG, discovered that both lost fat rather
than lean (muscle) tissue. He reasoned that hCG must be programming
the hypothalamus to do this in the former cases in order to protect
the developing fetus by promoting mobilization and consumption of
abnormal, excessive adipose deposits.
Simeons, practicing at Salvator Mundi International Hospital in
Rome, Italy, clinic mainly for celebrities, recommended low-dose
daily hCG injections (125 units) in combination with a customized
ultra-low-calorie (500 cal/day, high-protein, low-carbohydrate/fat)
diet loss of adipose tissue without loss of lean tissue. After
Simeons’ mysterious death, the diet started to spread to
specialized centers and via popularization by such as the
controversial author Kevin Trudeau.
The controversy proceeds from warnings by the Journal of the
American Medical Association and the American Journal of Clinical
Nutrition that hCG is neither safe, nor effective as a weight-loss
Anabolic steroid adjunct
In the world of performance enhancing drugs, hCG is increasingly
used in combination with various anabolic androgenic steroid (AAS)
cycles. As a result, hCG is included in some sports' illegal drug
When AAS are put into a male body, the body's natural
negative-feedback loops cause the body to shut down its own
production of testosterone via shutdown of the
hypothalamic-pituitary-gonadal axis (HPGA). This causes testicular
atrophy, among other things. hCG is commonly used during and after
steroid cycles to maintain and restore testicular size as well as
normal testosterone production.
High levels of AASs that mimic the body's natural testosterone
trigger, the hypothalamus, to shut down its production of
gonadotropin-releasing hormone (GnRH) from the hypothalamus.
Without GnRH, the pituitary gland stops releasing luteinizing
hormone (LH). LH normally travels from the pituitary via the blood
stream to the testes, where it triggers the production and release
of testosterone. Without LH, the testes shut down their production
In males, hCG helps restore and maintain testosterone production in
the testes by mimicking LH and triggering the production and
release of testosterone.
If hCG is used for too long and in too high a dose, the resulting
rise in natural testosterone will eventually inhibit its own
production via negative feedback on the hypothalamus and pituitary.