Which is more important, progesterone or human chorionic villus?

Generally speaking, both progesterone and human chorionic villus will promote gonadal hormones. The progesterone and human chorionic villus index data in the medical record can be used to diagnose whether a woman is pregnant in the early stages and whether the pregnancy is normal, so they are of great significance and reference value. As for which one is more important, it requires a specific examination by a doctor to define which one is more important based on personal constitution. However, in medicine, both are equally important, and their help to the human body is complementary and indispensable.

The following is a detailed explanation of the differences in terms of significance and impact:

Progesterone is the main biologically active progestogen secreted by the ovary. Before ovulation, the amount of progesterone produced per day is 2~3 mg, mainly from the ovaries. After ovulation, it rises to 20-30 mg per day, most of which is secreted by the corpus luteum in the ovary. Progesterone can protect the female endometrium. During pregnancy, progesterone can provide support and protection for the early growth and development of the fetus, and can have a certain calming effect on the uterus.

Whether progesterone drugs have an effect on the fetus depends on several aspects: the nature of the drug, the dosage of the drug, and the gestational age of injection. Progesterone is a drug for preserving pregnancy. The progesterone used for preserving pregnancy is natural, not artificially synthesized. Natural progesterone can be used to protect the fetus. As long as the progesterone hormone is lower than the normal value and the medication is taken strictly in accordance with the doctor's instructions, there will be no problem with the fetus. Natural progesterone generally only causes problems in two situations:

1. The level of progesterone hormone is normal, but you are still taking progesterone.

2. Not following the doctor's instructions and taking progesterone excessively or frequently.

When the above two situations occur, it will cause the male fetus to become feminine, and the female fetus will have excessive estrogen, making it more feminine. If it is artificially synthesized progesterone, the side effects will be greater and may cause abnormal embryo development, especially feminization of male fetuses. Also, because artificially synthesized progesterone contains norethindrone (which has a masculinizing effect), there is also a chance of masculinizing female fetuses.

Human chorionic gonadotropin (HCG) is a glycoprotein secreted by the trophoblastic cells of the placenta. It is of great significance for the diagnosis of early pregnancy and has certain value in the diagnosis, differentiation and course observation of pregnancy-related diseases, trophoblastic tumors and other diseases.

1. Diagnosis of early pregnancy: HCG can rise to greater than 2500 mIU/mL 35 to 50 days after pregnancy. It can reach 80,000 mIU/mL in 60 to 70 days. The urine HCG level in multiple pregnancies is often higher than that in single pregnancies.

2. Determination of abnormal pregnancy and placental function:

① Ectopic pregnancy: In the case of ectopic pregnancy, this test has only a 60% positive rate. HCG may still be positive 3 days after uterine bleeding, so HCG examination can be used to differentiate it from other acute abdominal diseases. HCG is usually 312-625 mIU/mL.

② Diagnosis and treatment of miscarriage: In case of incomplete miscarriage, if there is still placental tissue remaining in the uterus, the HCG test may still be positive. In case of complete miscarriage or stillbirth, the HCG test will turn from positive to negative, so it can be used as a reference for fetal preservation or uterine aspiration treatment.

③ Threatened abortion: If HCG levels in urine remain high, unavoidable abortion will not occur. If the HCG level is below 2500 mIU/mL and gradually decreases, there is a possibility of miscarriage or stillbirth. When it drops to 600 mIU/mL, miscarriage is inevitable. During the treatment to preserve pregnancy, if HCG continues to decrease, it means that the pregnancy preservation is ineffective. If HCG continues to rise, it means that the pregnancy preservation is successful.

④ 4 days after delivery or 13 days after artificial abortion, serum HCG should be lower than 1000 mIU/mL, and 9 days after delivery or 25 days after artificial abortion, serum HCG should return to normal. If this situation is not met, the possibility of abnormality should be considered.

3. Diagnosis and treatment monitoring of trophoblastic tumors

① The HCG level in the urine of patients with hydatidiform mole, malignant hydatidiform mole, choriocarcinoma and testicular teratoma is significantly elevated, which can reach 100,000 to millions of mIU/L. It can be diagnosed by dilution test. For example, the urine diluted at 1:500 is positive before 12 weeks of pregnancy, and the urine diluted at 1:250 is positive after 12 weeks of pregnancy, which is valuable for the diagnosis of hydatidiform mole. A positive urine test at a dilution of 1:100 to 1:500 also has diagnostic value for choriocarcinoma. If HCG levels in male urine are elevated, testicular tumors such as seminoma, malformations, and ectopic HCG tumors should be considered.

② For patients with trophoblastic cell tumors, urine HCG should be <50 mIU/mL 3 weeks after surgery and negative for 8 to 12 weeks. If HCG does not decrease or turn negative, it indicates that there may be residual lesions. Such cases are often prone to recurrence, so regular examinations are required.

4. Other factors such as menopause, ovulation and bilateral oophorectomy can all lead to elevated luteinizing hormone. Since LH and HCG have the same α-peptide chain composition, the pregnancy test using anti-HCG antibodies will be positive. At this time, a monoclonal two-point enzyme immunoassay of β-HCG can be used for identification. HCG levels may also increase in endocrine diseases such as pituitary diseases, hyperthyroidism, and gynecological diseases such as ovarian cysts and uterine cancer.