Possible Meanings of a High hCG Level in Pregnancy

Increased hCG isn't usually concerning during pregnancy

If your doctor has noted that your hCG level is high during pregnancy, it could be due to a variety of factors. During pregnancy, your body produces the hormone human chorionic gonadotropin (hCG). It can be detected by your doctor via a blood test roughly 11 days after conception and via a urine test approximately 12 to 14 days after conception. The level of this hormone usually reaches its peak between the second and third months of pregnancy and then drops.

What Causes hCG Levels to Increase

Determining what, exactly, constitutes a "high" hCG level can be difficult because the normal range of hCG levels in early pregnancy is wide, and hCG levels can rise and fall at different rates. Depending on how far along you are in your pregnancy, there are general guidelines that doctors use. 

A high hCG level could indicate a few different things, most of which are not concerning. It might mean the calculation of your pregnancy date is incorrect and that you're further along than you previously thought. It could also signal that you're having more than one child, such as twins or triplets. If you are taking fertility drugs, your levels of hCG increase as well. It could mean nothing at all – some women have a high hCG level and continue on with a normal pregnancy and have a single, healthy baby.

Less commonly, high hCG levels can indicate a significant complication with your pregnancy – namely a molar pregnancy.

About Molar Pregnancies

A molar pregnancy is a rare abnormality occurring in one out of every 1,000 pregnancies. Molar pregnancies are believed to result from a genetic mistake in the fertilizing sperm or egg, which causes the cells that would typically develop into a fetus to grow into a non-cancerous mass instead. As a result, there is no viable pregnancy.

If you are having a molar pregnancy, your doctor will usually be able to determine that the pregnancy is not viable after 12 weeks when there is no fetal movement or heart tone. A sonogram and pelvic exam will confirm a diagnosis.

You may experience high blood pressure, intense nausea or vomiting, anemia, hyperthyroidism, fast uterine growth, preeclampsia, ovarian cysts, the passage of the tumor through the vagina, and vaginal spotting or bleeding that's dark brown or bright red.

You may miscarry the molar pregnancy naturally or it may have to be removed through a procedure known as a dilation and curettage (D&C). During a D&C, your doctor will dilate your cervix and scrape the abnormal cells from your uterus. 

After a molar pregnancy, you may have to wait six months to a year to conceive again. Sometimes, after the molar tissue is removed, it can keep growing and cause complications, such as vaginal bleeding and even a rare form of cancer. If you have had a molar pregnancy, your doctor will continue to monitor you. They will test your hCG levels every couple of weeks until the levels go down to zero, and every couple of months thereafter. It is likely your doctor will want to pay careful attention to you during future pregnancies as well. Fifteen percent to 20% of women will develop complications that require chemotherapy treatments if hCG levels do not go down on their own. In very rare cases, a hysterectomy is performed when a woman if done having kids and wishes to eliminate future complications.

A Word From Verywell

If you are experiencing any unusual symptoms during your pregnancy or if your doctor is concerned about your hCG levels, he or she may re-check your hCG level in two or three days to see if it has changed. It is likely that your doctor will use several medical tools – such as a sonogram and a pelvic exam – in addition to monitoring your hCG level to get a broader picture of your pregnancy and your health.

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  3. Harvard Health Publishing. Molar Pregnancy: What Is It? 2019.

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