What does the presence of antibodies to hCG in blood tests show? Antibodies to hCG: exposure, diagnosis and methods of lowering

- immunoglobulins that damage the cells of the embryo and prevent the binding of chorionic gonadotropic hormone to receptors corpus luteum. The test for antibodies in the blood is performed when examining women planning a pregnancy, when monitoring the process of bearing a fetus, monitoring the effectiveness of artificial abortion, and detecting prostate and testicular cancer. The result of the analysis allows you to prevent/diagnose miscarriage, premature birth, intrauterine fetal death, identify malformations of the unborn child, and assess the progression of gonadal cancer (in men). Blood is taken from a vein and analyzed by ELISA. The normal value is up to 30 U / ml for IgM, up to 25 U / ml for IgG. Deadline - 1 day. In total, there were 59 addresses in Moscow where this analysis could be done.

- immunoglobulins that damage the cells of the embryo and prevent the binding of chorionic gonadotropic hormone to the receptors of the corpus luteum. The test for antibodies in the blood is performed when examining women planning a pregnancy, when monitoring the process of bearing a fetus, monitoring the effectiveness of artificial abortion, and detecting prostate and testicular cancer. The result of the analysis allows you to prevent/diagnose miscarriage, premature birth, intrauterine fetal death, identify malformations of the unborn child, and assess the progression of gonadal cancer (in men). Blood is taken from a vein and analyzed by ELISA. The normal value is up to 30 U / ml for IgM, up to 25 U / ml for IgG. Deadline - 1 day.

The main basis for the diagnosis of this kind is the patient's high-quality readiness for the onset of childbearing and untimely delivery, as well as the finding of symptoms provoking intrauterine freezing of the fetus.

Testing for the presence of antibodies is the most effective method for proving or denying female infertility.

General characteristics of hCG

Human chorionic gonadotropin is a hormone that is formed directly in the placenta at the very initial stage of pregnancy. It is produced by the shell of the embryo, which is called the chorion. When a woman is in position, her placenta becomes the producer of a certain number of hormones that are very important for proper flow pregnancy. These include testosterone, hCG, and estradiol.

The placenta is the most important organ, which promotes the development of chorionic gonadotropin, it also checks and controls the right process bearing a fetus.

The most important appointments of chorionic gonadotropin in the body of a woman in position are considered:

The hormone that is formed in the first stages of gestation in the cells of the embryo becomes an obstacle to stopping pregnancy due to the detachment of the endometrium.
HCG is a kind of stimulus for the development of the corpus luteum, whose functions are the production of progesterone and estrogens, which are especially important for proper growth embryo at an early stage of fertilization.
Chorionic gonadotropin also contributes to the development and increase of testosterone in the seeds of men even before the birth of the baby, this is necessary for the correct formation of male sexual signs.

It turns out that the embryonic organ is responsible for a well-running pregnancy, the most important of the hormones at this stage is hCG.

The main way to determine antibodies to hCG is enzyme immunoassay, which will help to find the bodies you are looking for, using the added conjugate, which tends to stain after binding to antibodies. But the color intensity of the color is directly proportional to the number of the desired substances found.

Impact

The process of the appearance of antibodies to this hormone is promoted by an autoimmune factor, which can result in stopping fertilization. The basis for the appearance of these antibodies in female body and remains completely unexplored.

Antibodies tend to affect the work of chorionic gonadotropin. This subsequently reduces the number of other hormones that are necessary for normal development fetus. Disorders that were caused by the presence of antibodies in the female body contribute to the formation of an unhealthy baby, a syndrome, after which pregnancy is often terminated.

Study preparation

Before carrying out the process, it is necessary to explain to the patient that the main intention is to examine and find the reasons due to which the interruption of the childbearing may occur. It is worth noting that during the period of these manipulations you will not need to change your diet and go on any diets. To diagnose the patient, you need to take blood tests and do venipuncture. A slight pain may be felt during a blood transfusion.

Women are screened for antibodies when:

The procedure for examining pregnancy at various stages.
Examination for presence normal pregnancy or outside the uterus.
Diagnosis of the consequences of a previous abortion.
Inspection, the characteristic process of gestation.
Control of the progression of various tumors and pathologies.
Monitoring the presence of fetal growth deficiencies in the early stages.

Men are prescribed such a diagnosis only if there is a special need for examination of pathologies of the genital organs.

The hCG hormone is made up of alpha and beta cells, but beta-hCG is endowed with special significance.

An analysis for the presence of antibodies to beta-hCG is performed when:

An examination is carried out for the presence of fetal growth disorders at the very initial stages of wearing.
Pregnant women are over the age of 35.
The existence of very severe defects in carrying a child in close relatives.

Doctors do not often enough prescribe an analysis to determine the amount of antibodies to hCG, despite the fact that many highly qualified specialists recommend doing these manipulations to every pregnant woman who has previously suffered an independent miscarriage.

This procedure is too problematic to carry out today, because the accessories necessary for this action are not present at all in every laboratory. Plus, the required number of reagents required for the procedure is not being developed in our country.

The number of antibodies during the normal functioning of the body should be less than 30 U / ml. When they are elevated, this is one hundred percent evidence of the most serious shortcomings and problems in the female body, and specifically in immune system. The number of antibodies, which is above the norm, forces a mandatory and pedantic examination of a woman who is carrying a child, or one that plans this process.

Indications for analysis

Cells that have a destructive effect on the hCG hormone are called antibodies in medicine. It is because of this that an independent stop of fertilization is carried out.

The study of the body for the presence of anti-hCG is performed:

In case of preterm pregnancy.
When a woman can't get pregnant for too long.

Depending on the gestation period, the norm varies in the range from 25 mU / ml to early dates up to 27-78 mU / ml, when the end of pregnancy is already approaching.

It should be noted that the study of the content of this hormone in the presence of ectopic pregnancy will almost always be positive.

Causes of violation of the norm of the chorionic hormone

Exceeding the norm of the indicator indicates the presence of the following pathologies in a male or female:

Malignant tumors of the genital organs.
Malignant growths in the organs of the digestive system.
Cancer of certain internal organs.

A large accumulation of chorion can be observed for several days after the interruption of gestation by artificial means.

HCG, which is at a high level, indicates multiple pregnancy about toxicosis. It can also cause diabetes in a pregnant woman.

Short hCG level shows:

Erroneous determination of the period of pregnancy.
The presence of a fetus forming outside the uterus.
The existence in the body of a woman is already a dead fetus.
The presence of problems and slowness in the process of fetal growth.

It happens that tests can indicate the absence of a hormone in the blood, this only indicates that the tests are carried out too early or that there is a phenomenon in the body of the formation of a fetus outside the uterus.

Immune system response to hCG

A huge number of experts believe that the main factor in the appearance of an incorrect reaction to the presence in the blood and a high amount of hCG may be that this hormone is chemical, what in full size not to be native to human body. The appearance of such a disease is associated with the existence of serious diseases in the body. Very often, during therapy, substances are used that help to reduce the possibility of creating unnecessary immune responses in the body.

The doctor treating a pregnant woman always advises a course of blood purification from the presence of harmful antibodies, such a manipulation is called plasmapheresis. The process is carried out completely without pain. This action can be carried out both during pregnancy and in preparation for it.

It should be noted that not always an increased level of antibodies in the blood is already a sentence for a woman. Treatment that was carried out at the right time and the appeal to the best doctors, who knows their business, helps to create a strategy and structure necessary actions, which lead to a decrease in the number of antibodies and to confidence in a properly proceeding pregnancy. Plus, the doctor will be able to give a hint and give advice on where to do the tests the fastest.

IMMUNOLOGICAL CAUSES OF RECURRENT MISSION OF PREGNANCY

It is now known that about 80% of all previously unexplained cases of recurrent pregnancy loss (after excluding genetic, anatomical, hormonal causes) is associated with immunological disorders.
There are autoimmune and alloimmune disorders leading to recurrent miscarriage.

· In autoimmune processes, the immune system develops aggression towards the mother's own tissues, i.e. the immune response is directed against their own antigens. In this situation, the fetus suffers a second time as a result of damage to maternal tissues.

In case of alloimmune disorders, the immune response of the pregnant woman is directed against the antigen of the embryo (fetus) obtained from the father and potentially foreign to the mother's body.

The autoimmune disorders most often found in patients with recurrent miscarriage include the presence of antiphospholipid, antithyroid, antinuclear autoantibodies in the blood of a pregnant woman. It was found that 31% of women with habitual miscarriage outside of pregnancy, autoantibodies to thyroglobulin, peroxidase are detected thyroid gland. In these cases, the risk of spontaneous miscarriage in the first trimester of pregnancy increases to 20%. In case of habitual miscarriage in the presence of antinuclear and antithyroid antibodies, further examination is indicated to identify the autoimmune process and verify the diagnosis.

The generally recognized autoimmune condition leading to the death of the embryo/fetus is currently APS.
ANTIPHOLIPIID SYNDROME
Epidemiology

According to American authors, the frequency of APS in the population reaches 5%, and among patients with recurrent miscarriage it is 27-42%, and without treatment, the death of the embryo (fetus) occurs in 85-90% of women with autoantibodies to phospholipids.

The main complication of APS is thrombosis: 22% of women with a history of APS have thrombosis, including 6.9% - cerebral thrombosis. The risk of thrombotic complications increases with the course of pregnancy and in the postpartum period. Their share among all thrombotic complications caused by an increase in the coagulation potential of the blood against the background of hypervolemia reaches 24%.

Classification, clinical manifestations and methods for diagnosing APS are presented in detail in the chapter "Antiphospholipid Syndrome".

In patients with APS, screening and medical preparation must be taken before pregnancy. With a positive test for lupus anticoagulant and the presence of antiphospholipid antibodies, the study should be repeated after 6–8 weeks. During this time, a comprehensive
examination and treatment of others possible complications with habitual pregnancy loss. With repeated positive tests for lupus anticoagulant and changes in hemostasiogram parameters, treatment should be started outside of pregnancy.
Treatment

APS therapy is selected individually depending on the severity of the activity of the autoimmune process.

Assign antiplatelet agents, anticoagulants, small doses of glucocorticoids, if necessary - plasmapheresis.

Without therapy, the birth of viable children is noted only in 6% of cases.

In women with "classic" APS with a history of thrombosis, heparin therapy is mandatory, from early pregnancy (from the moment of visualization of the fetal egg) under the control of coagulation tests, as well as acetylsalicylic acid at a dose of 81-100 mg / day, calcium and vitamin D preparations .

· If there is a history of preeclampsia, in addition to anticoagulant, antiplatelet therapy, immunoglobulin is indicated at a dose of 400 mg/kg of body weight for 5 days of each month.

In case of fetal loss without vascular thrombosis, anticoagulant and antiplatelet drugs are prescribed in low, maintenance doses (acetylsalicylic acid at a dose of up to 100 mg / day, heparin 10,000 IU per day, low molecular weight heparins in prophylactic doses).

In case of circulation of b2-glycoprotein-dependent antibodies to cardiolipin, even in high titers without thrombosis and miscarriage in history, drug therapy is not recommended, but only observation is indicated.

The main anticoagulant drugs used in obstetric practice are listed below.

Enoxaparin sodium at a prophylactic dose of 20–40 mg/day, at a therapeutic dose of 1 mg/kg of body weight (with distribution
daily dose for 1 or 2 subcutaneous injections).

· Dalteparin sodium 2500-5000 IU 1-2 times a day or 50 IU/kg of body weight.

Nadroparin calcium at a dose of 0.3-0.6 ml (2850-5700 IU) 1-2 times a day, at a therapeutic dose of 0.01 ml (95 IU) / kg of body weight 2 times a day.

However, it should be noted that the appointment of anticoagulants for the purpose of antithrombotic prophylaxis early termination pregnancy in women with thrombophilia and complicated pregnancy does not find unanimous recognition of the world's leading experts (S.Middeldorp.Antithrombotic prophylaxis for women with thrombophilia and pre-nancy complications-No // Journal of tombosis and haemostasis.- 2003.- Vol. 1 (10 ).- pp. 2073–2074.). The lack of a unified point of view on the possibility of preventing pregnancy complications in women with acquired thrombophilia does not allow us to unequivocally recommend their long-term administration.

Due to a number of specific effects (detoxification, rheocorrection, immunocorrection, increased sensitivity to endogenous and drug substances), plasmapheresis, when performed outside of pregnancy, can reduce the activity of the autoimmune process, normalize hemostasiological disorders before the gestation period.

Indications for plasmapheresis during pregnancy are given below.

· high activity autoimmune process.

Hypercoagulability as a manifestation of chronic DIC, not corresponding to the gestational age and not amenable to correction by medication.

· allergic reactions on the introduction of anticoagulants and antiplatelet agents.

Activation of infection (chorioamnionitis) during pregnancy with the appointment of glucocorticoids.

aggravation chronic gastritis and / or peptic ulcer of the stomach, duodenum, in which it is necessary to reduce the dose of glucocorticoids or stop immunosuppressive therapy.

The plasmapheresis technique includes exfusion for 1 session of 30% of the volume of circulating plasma (600–900 ml). Plasma substitution is carried out with colloid and crystalloid solutions. Outside of pregnancy, the volume of plasma removed is equal to the volume of plasma-substituting solutions, and during pregnancy, the latter is 1.2 times greater than the volume of plasma removed (using a 10% albumin solution in an amount of 100 ml).

Management of pregnancy in women with APS is presented below.

· From the early stages of gestation, it is necessary to control the activity of the autoimmune process, including the determination of lupus anticoagulant, the titer of antiphospholipid, anticardiolipin antibodies, hemostasiological control with individual selection of anticoagulant, antiplatelet and glucocorticoid therapy.

During the first 3 weeks of anticoagulant therapy, weekly monitoring is carried out general analysis blood with platelet count for timely diagnosis thrombocytopenia. In the future, it is necessary to monitor the level of platelets at least 2 times a month.

· According to ultrasonic fetometry, it is possible to monitor the adequacy of the growth and development of the fetus. From the 16th week of pregnancy, fetometry is carried out at intervals of 3–4 weeks to control the rate of fetal growth and the amount of OS.

· In the II and III trimesters, a study of the functions of the liver and kidneys is shown: the determination of proteinuria, the concentration of creatinine, urea, enzyme activity (ALT, AST) in the blood.

Doppler ultrasound for timely diagnosis and treatment placental insufficiency, as well as to evaluate the effectiveness of the therapy.

CTG from 33–34 weeks of gestation to assess the condition of the fetus and choose the timing and method of delivery.

In childbirth, careful cardiac monitoring is necessary due to the presence of chronic hypoxia fetus of varying severity, as well as increased risk PONRP, development acute hypoxia fetus on the background of chronic.

It is necessary to control the hemostasiogram immediately before childbirth and during childbirth.

· It is shown to monitor the condition of puerperas, since it is in the postpartum period that the risk of thromboembolic complications increases. Glucocorticoid therapy is continued for 2 weeks after delivery with the gradual withdrawal of drugs.

· Control of the hemostasis system is indicated 3 and 5 days after delivery. With severe hypercoagulability, it is necessary to prescribe a short course of low molecular weight heparins or unfractionated heparin for 10 days, 10,000–15,000 IU / day subcutaneously, acetylsalicylic acid at a dose of up to 100 mg / day for 1 month. In patients receiving antiplatelet agents and anticoagulants (for the prevention of thrombosis with severe and prolonged hypercoagulation), lactation is suppressed. With short-term changes in the hemostasis system after childbirth, amenable to drug therapy, breastfeeding can be delayed for the duration of treatment while maintaining lactation.

Information for the patient

If a patient is diagnosed with APS, then she should be informed about the need for treatment during pregnancy and monitoring of the fetal condition, as well as urgent medical attention if signs of venous thrombosis of the vessels of the legs appear (redness, swelling, pain along the veins).

Further management of the patient

In APS accompanied by vascular thrombosis, after the completion of pregnancy, hemostasiological control and observation by hematologists, vascular surgeons and rheumatologists is necessary.
ANTIBODIES TO PROGESTERONE

In 10% of women with recurrent miscarriage outside of pregnancy, autoantibodies to progesterone are detected in the blood.

In the presence of autoantibodies to progesterone, as a rule, luteal phase deficiency is determined, the concentration of progesterone is equal to the lower limit of the norm, and a “thin” endometrium is noted in terms of the “implantation window”. During pregnancy, primary placental insufficiency is often formed.

When antibodies to progesterone are detected, micronized progesterone or dydrogesterone is included in the treatment, and with a high level of autoantibodies, it is advisable to prescribe prednisolone at a dose of 5–10 mg / day from the 2nd phase of the menstrual cycle.
SENSITIZATION TO CHORIONIC GONADOTROPIN

Alloimmune factors of habitual miscarriage include the presence of antibodies to hCG.

In the blood of 26.7% of women suffering from recurrent miscarriage, antibodies to hCG are detected, which, having a high affinity, block the biological effect, and in some cases lead to a decrease in the concentration of hCG. The mechanism of action of AT probably consists not only in preventing the binding of hCG to the receptors of the ovarian corpus luteum, but also in a direct damaging effect on the cells of the embryonic trophectoderm. In 95% of women with high titers of antibodies to hCG, there is a threat of abortion in the first trimester. Abs to hCG during ELISA cross-react with LH and FSH, which is associated with the presence of common antigenic determinants. These hormonal and alloimmune disorders lead to early development DIC syndrome (from 3–8 weeks of gestation) and, as a result, inhibition of the hormone-producing and trophic function of the trophoblast.

The treatment of patients with sensitization to hCG consists in the correction of thrombophilia with the help of low molecular weight heparins under the control of a hemostasiogram and the administration of glucocorticoids at a dose of 5–15 mg / day per prednisone. Treatment should begin in the first trimester of pregnancy, since the peak production of hCG and, as a result, AT develops in the first weeks of pregnancy.
OTHER AUTOIMMUNE PROCESSES

Other alloimmune processes leading to fetal rejection include the presence of increased amount(more than 3) common antigens of the major histocompatibility complex system (often occurs in consanguineous marriages), low level blocking factors in the mother's blood, increased levels of NK cells (CD56+16+) in the endometrium and maternal blood both outside and during pregnancy, high levels in the endometrium and blood of a pregnant woman of a number of cytokines, in particular - interferon, tumor necrosis factora , IL-1, IL-2. Currently, these alloimmune factors leading to early pregnancy losses and ways to correct the above conditions are under study. There is no consensus on the methods of therapy. According to some researchers, active immunization with donor lymphocytes does not give a significant effect, other authors describe a significant positive effect when using lymphocytoimmunotherapy and immunoglobulin therapy.

Currently, one of the immunomodulating agents on early stages pregnancy is progesterone. Studies have shown the role of dydrogesterone in daily dose 20 mg in women with recurrent miscarriage in the first trimester of pregnancy elevated level CD56+16+ cells in the endometrium.
PREVENTION

Women with a history of 2 or more miscarriages or preterm births should be advised to be screened prior to the onset. next pregnancy to identify the causes, correct violations and prevent subsequent complications. Prevention methods depend on the underlying causes of recurrent miscarriage.
FORECAST

According to the data of multicenter randomized trials in accordance with the principles of evidence-based medicine, at present there is no reliable data on an increase in the number of children born in women with recurrent miscarriage in the appointment of preconception preparation, long-term bed rest, progesterone and its analogues, dexamethasone, low molecular weight heparin etc. Even without treatment, the birth rate of a child reaches 86%. However, it is not advisable to abandon the widespread method of treatment. By identifying the causes, correcting disorders outside of pregnancy, monitoring during pregnancy, the birth of viable children in couples with recurrent miscarriage reaches 95–97%

Antibodies to hCG are an indicator confirming the possibility of a threat of termination of a woman's pregnancy. The basis for conducting a survey of women is the qualitative preparation of a woman for pregnancy, the prevention of miscarriage and premature birth, as well as the identification of causes or prerequisites for intrauterine fetal death. Anti-hCG analysis is the most effective method confirmation or refutation of a woman's infertility.

Chorionic gonadotropin (hCG) is a hormone produced in a woman's placenta during pregnancy. HCG bodies are synthesized by the cell structures of the placenta and some types of tumors originating from trophoblastic tissue. During pregnancy, the placenta is an organ that produces a whole complex of biologically active compounds required for the normal bearing of a child.

To the list of the main functions of the hormone produced in the female body and developing fetus, include the following:

HCG during pregnancy, which is formed in the very early stages of the gestation process in the cells of the embryo, counteracts the process of premature termination of pregnancy, which occurs in the event of exfoliation of the endometrium.
HCG stimulates the corpus luteum, which is designed to produce progesterone, which is required for the normal development of the fetus.
HCG has a stimulating effect on the synthesis of testosterone in the testes of the fetus. This hormone is required for intrauterine development fetus and the development of male sexual characteristics of the unborn child.

The placenta is the main organ that performs the function of producing hCG and controlling normal course woman's pregnancy process.

The appearance of antibodies to hCG is attributed to autoimmune factors that can lead to abortion. The reason for the formation of these antibodies in the body is not fully identified. The mechanism of action, according to researchers, is manifested in the intervention of these bodies in the process of binding of chorionic gonadotropin to the receptors of the corpus luteum, i.e. gland, which is formed in the ovaries during pregnancy, as well as in the direct damaging effect on the cells of the embryo.

Antibodies to hCG affect the functioning of hCG, which leads to a decrease in the amount of other hormones required during optimal development fetus. Violations caused by the presence of antibodies to hCG in a woman's body lead to the appearance of DIC, which is dangerous for the child, the appearance of which often leads to a threat of spontaneous miscarriage.

When is an analysis for the presence of antibodies to hCG prescribed?

For female representatives, an examination for antibodies to hCG is prescribed in the following cases:

Carrying out diagnostics of pregnancy at its different terms.
Diagnosing the presence or absence of an ectopic pregnancy.
Carrying out diagnostics of the effectiveness of a previously performed artificial abortion.
Monitoring the nature of the course of the pregnancy process.
Carrying out diagnostics of the development or progression of tumor processes.
Diagnosis of fetal malformations on initial terms pregnancy.

For representatives of the male half of humanity, the appointment of such an examination is carried out in case of an urgent need to diagnose tumors of the prostate and testicles.

The hCG hormone includes alpha and beta particles. Highest value has free beta-hCG.

An analysis for the presence of antibodies to beta-hCG is carried out in the following cases:

Carrying out diagnostics for the presence of pathologies of fetal development in the first trimester of pregnancy.
Women carrying a child after the age of 35.
Availability serious problems development in one or more relatives of a pregnant woman.

Medical specialists rarely prescribe an analysis to determine the amount of an antibody to hCG, although, according to famous doctors, it should be performed for every woman who has had a spontaneous abortion. This analysis is quite difficult to pass today, since not every laboratory has the tools necessary for this procedure. A certain amount of reagents required for the implementation of medical research is not produced at the enterprises of the Russian industry. Laboratories develop their unique techniques, the results of which are interpreted. The analysis and its results rarely turn out to be insufficiently accurate and correct.

The amount of antibodies in the norm should not exceed the range of 0-30 IU / ml. If these values are exceeded, it is safe to say that in the body of a woman there are serious violations in the functioning of her immune system. An increase in the rate of antibodies in the body requires a more thorough examination and correction of the behavior of a pregnant woman or a woman who is just planning to become pregnant.

Taurus attacking and destroying hCG hormone, commonly called medical term"antibodies to hCG" This concept emphasizes the main reason for the natural termination of pregnancy. Antibodies to hCG are able to be synthesized under the influence of a viral illness, as well as as a result of hormonal imbalances.

An analysis for the presence of anti-hCG is prescribed:

if the woman had a previously miscarried pregnancy;
if a woman cannot get pregnant for a long time.

Depending on the gestational age hCG norm ranges from 25 mU / ml during the first and second weeks to 2700-78000 mU / ml, from 21 weeks until the end of pregnancy. For men and women, the hCG content is less than 5 mU / ml. The given values are averaged data, which can vary depending on the high quality of the factors. Only a highly qualified specialist is able to fully evaluate and decipher the results of the analysis.

HCG is normal

An analysis for the content of hCG in the development of an ectopic pregnancy is always positive. In the case of an ectopic pregnancy, the amount of hCG increases, the decoding of the analysis shows an increase, but it should be noted that this deviation is much lower than the established norm. Evidence of a small increase hCG is the fuzziness of the color of the second strip when using a pregnancy test. When normal developing pregnancy hCG indicators in the blood are elevated every few days. With ectopic development of the fetus, such an increase in the amount of the hormone in the blood does not occur.

What does a deviation from the norm of hCG mean?

Elevated hCG levels may indicate the presence in men or a non-pregnant woman of such serious diseases as:

malignant tumor of the testis;
malignant tumors in the organs of the gastrointestinal tract;
tumors in some internal organs.

Elevated concentrations of hCG can be observed for several days after artificial termination of pregnancy.

HCG above the norm indicates the presence of multiple pregnancy, preeclampsia and toxicosis. In addition, a significant increase in the hormone is observed with diabetes in a pregnant woman and possible deviations in fetal development.

A decrease in hCG below normal may indicate:

incorrect determination of the timing of pregnancy;
availability ectopic development fetus;
the presence of a frozen fetus in the body;
the presence of delays in the development of the fetus.

Sometimes the analysis may show the absence of hCG in the blood, which may indicate an early analysis or the presence in the body of the phenomenon of ectopic fetal development.

Chorionic gonadotropin is a hormone that prevents the rejection of the ovum during the development and gestation of the fetus. main reason lowering hCG is the synthesis of antibodies.

What are the reasons for the formation of an immune response to hCG in the body?

According to a large number researchers, the main reason for the occurrence of a painful reaction to the appearance in the blood and an increase in the concentration of hCG may be the fact that chorionic gonadotropin is a chemical substance that is not completely native to the woman's body. On initial stage pregnancy, within 2 months, hCG is produced fertilized egg, A later placenta. Usually, the immune response of the female body to the presence of this hormone in the blood is not formed. However, there are cases when the synthesis of antibodies to hCG is observed. These antibodies completely block the work of hCG, which leads to premature birth, miscarriage and miscarriage.

The formation of antibodies to hCG occurs for the following reasons:

In the presence of a defect in the body's immune system, which can occur as a result of the progression of a viral infection or genetic disorders.
In the case of procedures for stimulating the process of ovulation in a woman, which precedes IVF. In such cases, drugs are injected into the blood finished hCG. These substances are perceived by the woman's body as foreign, as a result of which the active production of antibodies begins.

The appearance of antibodies in the body indicates the existence of a high probability of a natural miscarriage in the event of pregnancy.

Effective ways to lower the number of antibodies

In case of detection of an increased content of antibodies in the blood, the choice of therapeutic measures is carried out depending on what immune status the woman has. The fact is that the occurrence of this pathology is closely interconnected with the presence of quite serious systemic diseases in the body. Most often, the treatment uses drugs that help reduce the likelihood of unwanted immune reactions of the body.

In addition, the attending physician, as a rule, recommends that a pregnant woman undergo a course of plasmapheresis to cleanse the body's blood of the presence of unwanted antibodies. The procedure is painless. Such an event can be carried out both during the period of preparation of the body for bearing the fetus, and in the process of its direct bearing.

It should be noted that it is not always high performance the presence of antibodies in the blood are a sentence for a pregnant woman. Timely appeal to qualified and knowledgeable specialists allows us to develop a set of necessary measures aimed at reducing the level of antibodies and ensuring the normal bearing of a child by a woman. In addition, the doctor will always be able to suggest where to take the test faster.

The appearance of antibodies to hCG is a symptom of immune disorders in a woman's body. This factor prevents the onset of pregnancy and its normal course. The exact cause of this deviation has not been identified, but there are several risk factors that can lead to this condition.

The interpretation of the results of the analysis in identifying the causes of infertility should be carried out comprehensively, taking into account other indicators. Exist special techniques to reduce high levels of antibodies.

What does the presence of antibodies to hCG indicate?

Human chorionic gonadotropin (hCG) is one of the main hormones that regulate processes in the female body during pregnancy. A week after the introduction of a fertilized egg into the uterine mucosa, the outer layer of the embryo begins to actively produce this substance. HCG signals the onset of pregnancy, which can be diagnosed by its content in the blood and urine in the early stages. This hormone gives a signal for the mother's body to further physiological transformations for the successful bearing of the fetus.

HCG performs the following functions:

stimulating the production of hormones in the sex glands, progesterone and estrogen in women, testosterone and dihydrotestosterone in men;
in non-pregnant women - regulation of maturation of follicles, ovulation and the formation of corpus luteum in the ovaries;
improvement of the susceptibility of the uterus, the formation of new blood vessels in the endometrium;
stimulation of the development of the organism of the embryo, regenerative processes in the postpartum period;
compensation for some pathologies of internal organs;
immunomodulatory effect, suppression of antigens that can lead to immune rejection of the fetus;
regulation of the activity of phagocytes - cells that devour bacteria and viruses.

HCG is produced in the membrane of the fetus and placenta, in the tissues of the fetus, the internal organs of children and adults of both sexes, as well as in rare tumors that form in the uterus and other organs.

The appearance in the body of antibodies to hCG (or in other words, sensitization to hCG) is an autoimmune factor that leads to a change in the above processes and to the threat of abortion. Antibodies disrupt the binding of chorionic gonadotropin to the receptors of the corpus luteum, reduce the production of other hormones necessary for the development of the fetus, contribute to the occurrence of DIC (blood clotting disorders, placental insufficiency and thrombosis of the placental vessels) and have a damaging effect directly on embryonic cells.

The chronic form of disseminated intravascular coagulation (DIC) in the placenta can develop as early as the 3-4th week of pregnancy. Antibodies to hCG become a marker of an incorrect immune response of the body of a pregnant woman, directed against her own cells and tissues of the fetus, which is half foreign (since it contains the father's genome).

In non-pregnant women, antibodies to gonadotropin can play a kind of protective role: an increase in their amount in the blood occurs in patients with uterine myoma (up to 60% of patients), which is one of the factors of infertility in this disease. During pregnancy, three periods are observed, which are characterized by an increase in the level of antibodies to hCG: 5-15, 21-25 and 30-33 weeks. Most often, spontaneous abortions occur on the 6-8th (76% of all cases), 25th (18%) and 34th (6%) weeks. In many cases, a woman may not notice a miscarriage, as it happens on early stage development and is rejected during menstrual bleeding.

Placental insufficiency develops due to the following mechanisms:

damage to the villi of the surface layer of the embryo, contributing to its attachment to the endometrium;
dystrophy of the main falling off membrane of the uterus and its death;
restructuring of the spiral arteries, thanks to which the necessary blood supply to the uterus is carried out during pregnancy.

Reasons for leveling up

The reason for the formation of antibodies to hCG has not yet been fully elucidated. The risk factors leading to this phenomenon are:

infectious diseases, chronic tonsillitis (in 46% of cases);
allergy (in 13% of patients);
hormonal disbalance;
medical abortions (33% of women) and spontaneous interruption pregnancy (from 5 to 76%, depending on the period at which the miscarriage occurred);
the presence of tumors;
reception medicines containing sex hormones (to stimulate ovulation).

Women who are hypersensitive to chorionic gonadotropin the following deviations are also revealed in the analyzes:

decrease in the level of luteinizing, follicle-stimulating and thyroid-stimulating hormones to the lower limit of the norm;
insufficiency of the luteal phase, manifested in the fall of estradiol and progesterone below acceptable levels;
increase in the content of lymphocytes with the CD56 phenotype by 4 times, CD19+5+ by 2 times;
activation of intravascular coagulation (up to 43% of cases).

When is an analysis prescribed, and how to take it?

Testing for antibodies to hCG is most often prescribed in the following cases:

infertility, the inability to conceive a child for a long time;
habitual miscarriage, spontaneous abortions and missed pregnancies;
numerous unsuccessful attempts get pregnant after IVF.

The analysis must be taken on an empty stomach, the last meal - no later than 3-4 hours. Additional training not required, time - any day of the menstrual cycle.

Blood is taken from a woman from a vein, after which it is examined using the ELISA method (enzyme-linked immunosorbent assay) to detect the levels of immunoglobulins of the IgM class (a marker of the disease in the acute period) and IgG (an indicator of antibodies formed 1.5-2 months after the acute period) . This examination can not be done in all laboratories (Dialab, Gemotest, TsIR - Center for Immunology and Reproduction). This is explained by the fact that the reagents required for the study are not produced by the Russian pharmaceutical industry.

The interpretation of the results is carried out as follows:

0< IgG< 25 Ед/мл, 0< IgM< 30 Ед/мл – норма; если показатели иммуноглобулинов приближаются к верхнему normal value- doubtful result (requiring additional examinations);
IgG> 25 U/ml, IgM> 30 U/ml – positive result, which shows the presence of abnormalities in the patient's immune system.

In some women, the values of these indicators can be much higher than normal (more than 160 U / ml). With such results, pregnancy is almost impossible even with the help of assisted reproductive technologies.

Consequences and prognosis for pregnant women

Pregnancy hypersensitivity to chorionic gonadotropin can have the following negative consequences:

miscarriage (more than half of patients);
placental insufficiency, which in the 3rd trimester is observed in 54% of pregnant women and entails the risk of abortion, acute fetal hypoxia;
violation of the process of implantation of the embryo into the uterus;
development chronic form DIC syndrome (from the 3rd week of pregnancy);
slowing down the "maturation" of the placenta;
decrease in blood supply to the placenta, the peak of which falls on the 30-33rd week;
early rupture of amniotic fluid;
with a very high concentration of antibodies - malnutrition and prematurity in newborns.

Particularly unfavorable for the fetus is the combination of antiphospholipid syndrome and sensitization to hCG. However, there is currently no proven causal relationship between these complications and antibody levels in medical science.

Risk spontaneous abortions more related to the amount of antibodies, rather than their presence. According to TsIR experts, the presence of antibodies in the blood is not in itself the only significant indicator of miscarriage. Women with multiple miscarriages or infertility should have comprehensive examination aimed at determining the hormone 17-OHP, serological markers of antiphospholipid syndrome and other data.

Can antibodies be reduced?

The detection of antibodies poses a great threat to the pregnant woman and the fetus, but there is a complex treatment method that helps to reduce the risk of complications by 3 times. It includes:

1. Glucocorticoid therapy (Metipred, Prednisolone). During periods of increased antibodies to hCG, the dosage is increased.
2. Antithrombotic medicines(injections of Heparin, Fraxiparin, Fragmin, Curantil, Reopoliglyukin).
3. Means for the treatment of placental insufficiency (Partusisten, Ginipral, Actovegin and others).

In non-pregnant women additionally apply the following drugs and methods:

gestagenic agents to eliminate the insufficiency of the luteal phase (Utrozhestan, Iprozhin);
immunomodulatory and metabolic drugs (Wobenzym, intravenous immunoglobulins);
plasmapheresis - purification of blood passed through a special apparatus;
gynecological examination to detect abnormalities (tumors, polyps, endometritis and other diseases) and appropriate treatment.

Normalization of antibody levels requires a significant amount of time - up to 2-3 months or more.

To identify the causes of infertility, a man and a woman must also be tested for the immune compatibility of partners for conception. During pregnancy, every 2-5 weeks it is necessary to monitor the level of antibodies to hCG. Complex therapy allows you to successfully become pregnant and bear a child without negative consequences.