A blood test with a number, and straight away the question: is that level normal? Here you will find hCG levels by week of pregnancy and by days since ovulation, how fast hCG rises, and what levels that are too low or too high can mean. The tables describe groups. Your gynecologist or your fertility practice will assess whether your level fits how your pregnancy is progressing.
Data box: How wide the normal levels are
In a lab table from the test manufacturer Roche, hCG levels in healthy pregnant women in the 7th week of pregnancy (6+0 to 6+6) ranged from 158 to 31,795 mIU/ml (5th to 95th percentile), a 200-fold difference (Roche, Ulm University Hospital 2020). A US guideline paper states that a single hCG level, no matter how high, does not reliably distinguish a viable pregnancy from an ectopic pregnancy (Doubilet 2013).
What is hCG?
The body produces hCG (human chorionic gonadotropin) as soon as the fertilized egg has implanted in the uterine lining. This happens 6 to 12 days after ovulation, in 84% of pregnancies on the 8th, 9th, or 10th day (Wilcox 1999). In the blood, hCG can be measured at the earliest about 6 days after fertilization (Ulm University Hospital 2020).
The lab report is often labeled beta hCG or β-hCG because the tests detect the beta subunit of the hormone. The units mIU/ml, IU/l, IE/l (the German abbreviation for IU/l), and U/l all mean the same numerical value.
hCG levels chart by week of pregnancy
The table comes from the package insert of the Roche test Elecsys HCG+β, which many German laboratories use. Counting starts on the first day of the last period. “4+0 to 4+6” means 4 completed weeks (4 weeks pregnant), which is the 5th week of pregnancy.
| Week of pregnancy | Weeks + days | Median (mIU/ml) | 5th to 95th percentile (mIU/ml) |
|---|---|---|---|
| 4th week | 3+0 to 3+6 | 17.5 | 5.8 to 71.2 |
| 5th week | 4+0 to 4+6 | 141 | 9.5 to 750 |
| 6th week | 5+0 to 5+6 | 1,398 | 217 to 7,138 |
| 7th week | 6+0 to 6+6 | 3,339 | 158 to 31,795 |
| 8th week | 7+0 to 7+6 | 39,759 | 3,697 to 163,563 |
| 9th week | 8+0 to 8+6 | 90,084 | 32,065 to 149,571 |
| 10th week | 9+0 to 9+6 | 106,257 | 63,803 to 151,410 |
| 11th week | 10+0 to 10+6 | 85,172 | 46,509 to 186,977 |
| 13th week | 12+0 to 12+6 | 66,676 | 27,832 to 210,612 |
| 15th week | 14+0 to 14+6 | 34,440 | 13,950 to 62,530 |
| 16th week | 15+0 to 15+6 | 28,962 | 12,039 to 70,971 |
| 17th week | 16+0 to 16+6 | 23,930 | 9,040 to 56,451 |
| 18th week | 17+0 to 17+6 | 20,860 | 8,175 to 55,868 |
| 19th week | 18+0 to 18+6 | 19,817 | 8,099 to 58,176 |
Source: Roche Elecsys HCG+β package insert, in the test directory of Ulm University Hospital (Ulm University Hospital 2020). The table gives no values for the 12th and 14th weeks of pregnancy.
How to read the table:
- Median: half of the pregnant women were below it, half above.
- 5th to 95th percentile: 90 out of 100 healthy pregnant women were in this range, 5 below and 5 above. A level outside it is therefore not automatically abnormal.
- Small groups: Up to the 13th week, each row is based on only 13 to 43 women. That is why the lower limit in the 7th week is even lower than in the 6th week (Ulm University Hospital 2020).
Why hCG charts differ so much
If you compare several charts, you will find very different numbers for the same week. For the 7th week of pregnancy, for example:
| Source | Lower limit, 7th week (mIU/ml) | Type of limit |
|---|---|---|
| Roche package insert | 158 | 5th percentile |
| Siemens package insert | 2,560 | 2.5th percentile, weeks 6 to 7 from the last period |
| Oregon Health & Science University | 4,000 | approximate range, week 6 to under 7 |
Sources: Ulm University Hospital 2020, Siemens Immulite 2009, OHSU.
The reasons:
- Different tests. The manufacturers sometimes measure different forms of hCG and calibrate to different standards. A large Rotterdam study states explicitly that its values do not match results from other tests (Korevaar 2015).
- Different dating. Whether the week is determined from the last period or by ultrasound shifts the values. Levels dated from the last period were lower (Korevaar 2015).
- Weeks are counted differently. Some charts count completed weeks (“week 6” = 6+0 to 6+6), others the current week (“6th week” = 5+0 to 5+6), and some count from conception.
Ulm University Hospital advises always measuring serial levels with the same method (Ulm University Hospital 2020). So compare your level with your lab’s reference range, not with a chart from the internet.
hCG by days past ovulation
For the days around the expected period, there are measurements from daily urine samples of 109 women. Ovulation was defined as the day after the LH peak (Gnoth and Johnson 2014). These are urine levels; levels in the blood are different.
| Days past ovulation (DPO) | Median in urine (mIU/ml) | 10th to 90th percentile |
|---|---|---|
| 7 DPO | 0 | 0 to 0.2 |
| 8 DPO | 0.1 | 0 to 2.9 |
| 9 DPO | 4 | 0.2 to 11 |
| 10 DPO | 12 | 3.9 to 27 |
| 11 DPO | 25 | 9.5 to 58 |
| 12 DPO | 48 | 16 to 94 |
| 13 DPO | 75 | 29 to 197 |
| 14 DPO | 137 | 45 to 301 |
| 15 DPO | 208 | 87 to 465 |
| 16 DPO | 334 | 139 to 854 |
| 17 DPO | 525 | 210 to 1,314 |
| 18 DPO | 814 | 284 to 1,769 |
| 19 DPO | 1,187 | 426 to 2,976 |
| 20 DPO | 1,645 | 663 to 4,170 |
| 21 DPO | 2,682 | 935 to 6,470 |
Source: Gnoth and Johnson 2014; the co-author works for SPD, the manufacturer of Clearblue.
With a 28-day cycle, 14 DPO is roughly the day your period is due. Another study measured an average of 49 mIU/ml in urine on this day, and in 5% of pregnant women the levels were below 12.4 mIU/ml (Cole 2004). That is why not every test is already positive on the day your period is due. The pregnancy test comparison shows which test has which detection limit, and the Pregnancy Test Calculator shows the right test day.
How fast does hCG rise?
In the first weeks, hCG rises quickly. In women who later had a viable pregnancy in the uterus, the level rose by a median of 124% in 48 hours, which is slightly more than doubling. The slowest rise that was still normal was 53% in 48 hours (Barnhart 2004). With high starting levels, less is enough: 49% below 1,500 mIU/ml, 40% between 1,500 and 3,000, 33% above 3,000 (Barnhart 2016).
The higher the level, the more slowly it doubles (Pittaway 1985). The rule of thumb “doubling every 48 hours” therefore describes the average in the first weeks, not the line between normal and abnormal. Converted, this means:
| Rise in 48 hours | corresponds to doubling in about | Interpretation |
|---|---|---|
| 124% | 41 hours | median of viable pregnancies (Barnhart 2004) |
| 63% | 68 hours | threshold of the British NICE guideline |
| 53% | 78 hours | slowest normal rise (Barnhart 2004) |
| 33% | 117 hours | lower limit with starting levels above 3,000 (Barnhart 2016) |
The doubling time is calculated as the interval between the measurements in hours × ln(2) ÷ ln(second value ÷ first value).
For the check, the practice takes two blood samples, ideally exactly 48 hours apart (NICE NG126). The Due Date Calculator in the section on the hCG rise puts levels after fertility treatment and how they rise into context.
hCG level too low
A level below the median is usually no cause for concern, because the normal range is very wide. Common reasons for a low level:
- The pregnancy is less advanced than thought. In one analysis, dating by the last period gave the right week in only 46% of cases, and in 78% it was off by one week at most (Mustafa and David 2001, cited in Gnoth and Johnson 2014). A late ovulation shifts everything later. The British NICE guideline points out that the last period often does not accurately reflect the gestational age (NICE NG126).
- Late implantation. When implantation happened later than day 10 after ovulation, the risk of an early miscarriage was considerably higher (Wilcox 1999).
- A pregnancy that is not developing further, or a chemical pregnancy.
- An ectopic pregnancy. The levels are often low in this case, frequently below 1,000 mIU/ml (Doubilet 2013).
What matters is the course. The NICE guideline, intended for pregnancies whose location cannot yet be seen on ultrasound, interprets two levels taken 48 hours apart as follows (NICE NG126):
| Course over 48 hours | What NICE concludes |
|---|---|
| Rise of more than 63% | probably a developing pregnancy in the uterus, ultrasound to determine its location, an ectopic pregnancy is not ruled out |
| Fall of more than 50% | the pregnancy is probably not continuing, urine test 14 days later |
| Rise of less than 63% or fall of less than 50% | medical assessment within 24 hours |
An ectopic pregnancy has no typical hCG pattern. In a US study, in 20.8% of women with an ectopic pregnancy, hCG rose as quickly as in a viable pregnancy (Silva 2006). NICE therefore advises giving symptoms more weight than individual hCG levels (NICE NG126). If you have one-sided abdominal pain, shoulder pain, bleeding, or dizziness, get examined right away.
hCG level too high
A high level is also usually within the normal range, because the upper limits are wide. Possible reasons:
- The pregnancy is further along than thought, for example after an early ovulation.
- Twins or multiples. In a small study, the peak in twins averaged 171,000 U/l, and in singletons 65,500 U/l (Grün 1997). However, the ranges overlap, and the rate of rise is the same (Chung 2006). Only an ultrasound shows whether it is twins.
- Molar pregnancy. A rare abnormal development of the placenta in which the levels are usually very high (Horowitz 2021). However, levels above 100,000 mIU/ml also occur in normal singleton pregnancies, see the chart. The diagnosis is made by ultrasound.
hCG and ultrasound
The hCG level at which something can be seen on ultrasound depends on the device, the examiner, and the lab test. A US study using transvaginal ultrasound found the following in pregnancies that later turned out to be viable (Connolly 2013):
| Finding | earliest seen from (mIU/ml) | seen in 99% from (mIU/ml) |
|---|---|---|
| Gestational sac | 390 | 3,510 |
| Yolk sac | 1,094 | 17,716 |
| Embryo | 1,394 | 47,685 |
If no gestational sac can be seen yet with a single level below 3,000 mIU/ml, a US expert consensus says an ectopic pregnancy should not be treated prematurely, because a viable pregnancy is still possible (Doubilet 2013). The Due Date Calculator in the section After the positive test shows which findings to expect in which week.
hCG without pregnancy
| hCG in the blood | Interpretation |
|---|---|
| below 5 mIU/ml | not pregnant (Doubilet 2013) |
| 5 to 25 mIU/ml | gray zone, may be a very early pregnancy, recheck after 48 hours (Abbott) |
| above 25 mIU/ml | suggests a pregnancy (Abbott) |
From about the age of 40, the pituitary gland can itself produce small amounts of hCG. For women over 55, one study recommends considering a level abnormal only from 14 IU/l (Snyder 2005). After a miscarriage, a pregnancy that has ended, or a trigger shot, hCG can remain detectable for some time.
hCG after fertility treatment
The trigger shot before ovulation or egg retrieval often contains hCG. Ovitrelle can cause a false positive pregnancy test for up to 10 days afterward (Ovitrelle 2020); in one study, injected hCG was measurable in the blood for up to 14 days (Damewood 1989). Stick to the test day set by your fertility practice.
After an embryo transfer, different levels apply than after natural conception, because the measurement is made in days after the transfer. The Due Date Calculator in the section hCG levels after blastocyst transfer shows published levels after fresh and frozen embryo transfers.
Urine or blood?
- Urine test: only shows positive or negative. Depending on the brand, home tests turn positive from a level of 6.3 to 50 mIU/ml (Butler 2001), early tests from 10 mIU/ml. The concentration in urine varies with how much you drink and is highest in the morning (FDA 2019).
- Blood test: measures hCG as a number, is positive earlier, and is suitable for monitoring the course.
hCG and nausea
Nausea and hCG both peak in the first trimester. However, there is no hCG level at which nausea starts. The British professional body RCOG now considers hCG an unlikely cause. In severe nausea, higher levels were found for another hormone of the placenta, GDF15 (RCOG 2024, Fejzo 2024). More on nausea as a sign of pregnancy is in the guide Early signs of pregnancy.
Frequently asked questions
What hCG level is normal in the 5th week of pregnancy?
In the 5th week of pregnancy (4+0 to 4+6), the median in the Roche table was 141 mIU/ml, with 90% of levels between 9.5 and 750 mIU/ml (Ulm University Hospital 2020). Other lab tests have other ranges.
What hCG level is normal in the 6th week of pregnancy?
In the 6th week of pregnancy (5+0 to 5+6), the median was 1,398 mIU/ml, with 90% of levels between 217 and 7,138 mIU/ml (Ulm University Hospital 2020).
How fast does hCG need to double?
In viable pregnancies, hCG rose by a median of 124% in 48 hours. The slowest normal rise is considered to be 53% in 48 hours, and even less with higher starting levels (Barnhart 2004, Barnhart 2016).
What does it mean if the hCG level is too low?
Usually, the pregnancy is less advanced than thought. However, a low level can also point to a pregnancy that is not developing further, or to an ectopic pregnancy. A second level after 48 hours and an ultrasound provide clarity (NICE NG126).
At what hCG level can something be seen on ultrasound?
In one study, a gestational sac could be seen from 390 mIU/ml at the earliest, and in 99% of viable pregnancies from 3,510 mIU/ml (Connolly 2013).
Can hCG levels show twins?
No. Twins have higher levels on average, but the ranges overlap considerably (Grün 1997, Chung 2006). Only an ultrasound shows it for certain.
At what hCG level are you pregnant?
In the blood, a level below 5 mIU/ml counts as not pregnant, and above 25 mIU/ml as pregnant. In between, the level is rechecked after 48 hours (Doubilet 2013, Abbott).
At what hCG level does nausea start?
There is no evidence-based level for this. According to current knowledge, nausea is mainly linked to the hormone GDF15 (RCOG 2024).
Sources
Laboratories and manufacturers
- Beta-HCG, test directory with the table from the Roche Elecsys HCG+β package insert, Ulm University Hospital (Universitätsklinikum Ulm), Clinical Chemistry, as of 8 July 2020
- IMMULITE 2000 HCG, package insert PIL2KCG-26, Siemens Medical Solutions Diagnostics, 2009
- HCG Beta Quant, Blood, Oregon Health & Science University Lab Services
- Total β-hCG, interpretation notes based on the Abbott Alinity package insert, Summa Health
- Ovitrelle 250 micrograms pre-filled syringe, package leaflet, Merck, as of October 2020
Guidelines and authorities
- Ectopic pregnancy and miscarriage: diagnosis and initial management, NICE guideline NG126, updated 17 June 2026
- Doubilet PM, Benson CB, Bourne T et al.: Diagnostic criteria for nonviable pregnancy early in the first trimester, N Engl J Med 2013;369:1443-1451
- Nelson-Piercy C et al.: The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum, Green-top Guideline No. 69, RCOG, BJOG 2024
- Home Use Tests: Pregnancy, U.S. Food and Drug Administration, as of 29 April 2019
Studies
- Korevaar TIM, Steegers EAP, de Rijke YB et al.: Reference ranges and determinants of total hCG levels during pregnancy, the Generation R Study, Eur J Epidemiol 2015;30:1057-1066
- Gnoth C, Johnson S: Strips of Hope, Accuracy of Home Pregnancy Tests and New Developments, Geburtshilfe Frauenheilkd 2014;74:661-669, co-author employed by SPD
- Wilcox AJ, Baird DD, Weinberg CR: Time of implantation of the conceptus and loss of pregnancy, N Engl J Med 1999;340:1796-1799
- Cole LA, Khanlian SA, Sutton JM, Davies S, Rayburn WF: Accuracy of home pregnancy tests at the time of missed menses, Am J Obstet Gynecol 2004;190:100-105
- Barnhart KT, Sammel MD, Rinaudo PF et al.: Symptomatic patients with an early viable intrauterine pregnancy, HCG curves redefined, Obstet Gynecol 2004;104:50-55
- Barnhart KT, Guo W, Cary MS et al.: Differences in serum human chorionic gonadotropin rise in early pregnancy by race and value at presentation, Obstet Gynecol 2016;128:504-511
- Pittaway DE, Reish RL, Wentz AC: Doubling times of human chorionic gonadotropin increase in early viable intrauterine pregnancies, Am J Obstet Gynecol 1985;152:299-302
- Chung K, Sammel MD, Coutifaris C et al.: Defining the rise of serum HCG in viable pregnancies achieved through use of IVF, Hum Reprod 2006;21:823-828
- Silva C, Sammel MD, Zhou L et al.: Human chorionic gonadotropin profile for women with ectopic pregnancy, Obstet Gynecol 2006;107:605-610
- Connolly A, Ryan DH, Stuebe AM, Wolfe HM: Reevaluation of discriminatory and threshold levels for serum β-hCG in early pregnancy, Obstet Gynecol 2013;121:65-70
- Grün JP, Meuris S, De Nayer P, Glinoer D: The thyrotrophic role of human chorionic gonadotrophin in the early stages of twin versus single pregnancies, Clin Endocrinol 1997;46:719-725
- Horowitz NS, Eskander RN, Adelman MR, Burke W: Gestational Trophoblastic Disease, Current Evaluation and Management, Obstet Gynecol 2021;137:355-370
- Snyder JA, Haymond S, Parvin CA et al.: Diagnostic considerations in the measurement of human chorionic gonadotropin in aging women, Clin Chem 2005;51:1830-1835
- Damewood MD et al.: Disappearance of exogenously administered human chorionic gonadotropin, Fertil Steril 1989;52:398-400
- Butler SA, Khanlian SA, Cole LA: Detection of early pregnancy forms of human chorionic gonadotropin by home pregnancy test devices, Clin Chem 2001;47:2131-2136
- Fejzo M, Rocha N, Cimino I et al.: GDF15 linked to maternal risk of nausea and vomiting during pregnancy, Nature 2024;625:760-767
