What is the ECG norm hCG. DPP - what is it. Table of hCG after IVF standards

In vitro fertilization - for manysteam is probably the last chance to get such a desirable child. One of the most important indicators that a pregnancy is developing normally is the hormone hCG. DPP - this indicator is also very important in the assessment of pregnancy that occurs after IVF. Let's see what is hidden under these abbreviations.

IVF - what's the point

Of course, everyone knows that in order toa child has appeared, the spermatozoon (male germ cell) must meet and fertilize an egg cell (female germ cell). After that, it is embedded in the mucous membrane of the uterus, undergoes a series of changes that take place over nine months, after which the child is born. Often the cause of infertility is the inability to carry out these two processes in vivo. That is, for a number of different reasons, spermatozoa are not able to fertilize an egg independently, or an already fertilized egg cannot reach the uterus or penetrate it. But at the same time the woman is quite capable of carrying the child. And then the doctors enter the business. Taking the germ cells of both parents, they perform artificial insemination and inject the resulting embryo into the endometrium. Of course, this description is very sketchy. Thus, the process of conception is somewhat simplified, and many couples get a chance.

DPP

The fertilized egg (embryo) is implantedin the uterus on day 3 or 5 after fertilization. At the same time, during the procedure, not one, but two embryos are implanted immediately. This increases the chances that the pregnancy will come. Nevertheless, there is a great risk that you will have to repeat this procedure several times. It happens that the embryo takes root, not even on the second, but on the fourth or fifth attempt. DPP stands for how many days have passed since the embryo was introduced. This date is very important to make sure that the pregnancy has come, you need to wait for 14 DPP. HCG, the level of which is measured at this time, is the main marker of this event.

Hormone hCG

Human chorionic gonadotropin (hCG) is normalis determined only in the body of a pregnant woman. The egg cell starts producing it, but since it enters the body of a woman already fertilized, the appearance of this hormone in a blood test or in the urine means that the embryo has been introduced successfully. It is believed that pregnancy has occurred, if hCG on 14 DPS five days (embryos that were introduced on the fifth day after fertilization) at least 100 mIU / L. If the figures are 25 mIU / L and lower, then, most likely, the procedure will have to be repeated. However, the low values ​​of this analysis can be in the case if the time after the embryo has passed is not enough, for example, they determine the hCG by 12 DPS.

What shows hCG

Chorionic gonadotropin is also called a hormone.of pregnancy. Immediately after fertilization, it does not allow the corpus luteum to regress and stimulates the synthesis of hormones such as estrogen and progesterone. In the serum, hCG is determined immediately after the egg has penetrated the lining of the uterus. After that, its concentration begins to grow rapidly. In the normal course of pregnancy every two days, it is doubled. The maximum rate of hCG (DPP) is recorded on the tenth week. After that, the level of this hormone gradually decreases over a period of 8 weeks, and then remains stable until delivery.

It should be noted that doctors closely monitorserum level of hormone and hCG - DPP ratio also because significant deviations of this indicator from the limits of the norm often become a marker of serious pathologies both in the mother’s body and in the development of the fetus.

Methods for the determination of chorionic gonadotropin

У большинства женщин после успешного ЭКО Changes in hCG levels begin to be monitored as early as day 9–14. In order to reveal its appearance, it is not even necessary to donate blood. Pregnancy tests work on the principle of determining its presence in the urine. Of course, they do not indicate the exact figures and the amount of hCG on DPP five days or three days, but its very presence with a high degree of probability indicates the occurrence of pregnancy. For more accurate results, a woman gives blood. If during normal pregnancy, blood for hormones is given during screening, which is carried out in the first trimester, then during extracorporeal fertilization for a more informative picture, gynecologists recommend doing this every 2–3 days after embryo insertion. The results obtained are compared with a table that lists the minimum, maximum and average values ​​of hCG for a certain period of the DPP.

Norms hCG

Like all indicators, the level of hCG canvary within certain limits. Most often, the table shows the data of fluctuations of its level by weeks of pregnancy. There are also tables showing the increase in the level of the hormone hCG by day. They are most relevant to those who are IVF. In the table below, only average values ​​are indicated on the day after implantation (DFS) for embryos that were implanted 3 and 5 days after fertilization.

As you can see, hCG on 7 DPP five-day daysis 45 mIU / l, but normally it can vary from 17 to 65 mIU / l. On the same day, the average for a three-day embryo will be 18, and the limits of the norm will be 8-26 mIU / L.

Reasons for increasing hCG

As already mentioned, hCG is not onlyindicator that the pregnancy has come, but also allows you to control its course. In that case, if the level of this hormone is not much beyond the normal range, then this is not particularly important, but if the indicators of hCG DPP do not correspond significantly, then this can be a signal of the presence of serious pathologies of both the mother and the fetus. A significant increase in this indicator can lead to:

• chromosomal abnormalities in fetal development (Down syndrome);
• trophoblastic tumors;
• endocrine disorders (diabetes);
• taking medications containing gestagens;
• multiple pregnancy.

Reasons for lowering hCG

Low levels of chariotic gonadotropin may be recorded in the following cases:

• threatened abortion;
• missed abortion;
• fetal malformations;
• fetal fetal death;
• post-pregnancy;
• placental insufficiency;
• ectopic pregnancy.

Increased hCG on DPP. Twins

When IVF in order to increase the chances of a womantwo embryos are implanted at once, but this often does not guarantee the success of the procedure. However, there are some precedents when both take root immediately. In this case, the indicators of hCG can increase by 2–3 times. This is due to the fact that it is not produced by one placenta, as is the case with singleton pregnancy, but immediately by two. For example, if the level of hCG on 16 dpps of five-day females averages 1960 mIU / l, then for twins the normal rate would be 3920 mIU / l and above.

HCG indicator in the diagnosis of fetal developmental abnormalities

Of course, pregnancy is important and expected.an event in the life of any woman, but it happens that she brings not only joy, but also experiences. Against the background of stress, ecology and other factors that do not in the best way influence the life that originated, there is a risk of developing pathologies. The modern level of medicine allows many of them to diagnose and even correct in the early stages. For this purpose, mandatory screenings are carried out in the first and second trimester of pregnancy. Screening for the first trimester, which is usually carried out over a period of 10–14 weeks, includes an ultrasound scan and control of the levels of the hCG and PAPP-A. Screening for the second trimester is carried out at 16-18 weeks. In it, along with ultrasound, conduct a triple test (hCG, AFP, estriol). The data of the second screening allow to determine the presence of pathologies with high probability. In the event that, against the background of low levels of AFP and estriol, the level of hCG significantly exceeds the norm, it is very likely that Down syndrome is present in the fetus. Edwards or Patau syndromes can be suspected with a low level of all three markers. Relatively normal indicators of chorionic gonadotropin with low AFP and estriol may indicate Turner syndrome.

All forecasts are made on the basis of individualcharacteristics of the ongoing pregnancy - the age of the mother, her weight, the presence of bad habits, comorbidities, diseases in children born in previous pregnancies. If the survey revealed even minor deviations from the norm, the woman is necessarily sent to a geneticist for consultation.

How to take an analysis

For analysis of hCG, blood from a vein is required.To do this better in the morning and strictly on an empty stomach. In the event that you have to take it during the day, you must refrain from eating for at least 6 hours. In the event that you are taking any drugs containing hormones ("Pregnil", "Horagon"), you need to warn the doctor in advance.

Для того чтобы лабораторное исследование было more informative, do it better not earlier than in 3-5 days after the delay of menstruation. In the case of IVF, the most accurate data will be diagnosed on day 14 after the procedure.