Hyperglycosylated hCG (invasive trophoblast antigen, ITA) a key antigen for early pregnancy detection.
OBJECTIVE
Hyperglycosylated human chorionic gonadotrophin (hCG) is an hCG variant with extra-large O-linked oligosaccharides, produced by phenotypically invasive cytotrophoblast cells in choriocarcinoma and pregnancy. It is the principal form of hCG produced in the first weeks of gestation. We investigated the importance of hyperglycosylated hCG in pregnancy testing and its detection by current hCG tests.


METHODS
We measured the concentration of hyperglycosylated hCG and total hCG in 512 pregnancies throughout gestation. We assessed and compared the abilities of 14 commonly used commercial laboratory hCG tests and 18 home pregnancy tests to detect regular and hyperglycosylated hCG.


RESULTS
Hyperglycosylated hCG is the principal source of hCG-related immunoreactivity in early pregnancy. In the week following missing menses, hyperglycosylated hCG measurements may be more sensitive than regular hCG measurements in detecting pregnancy. Of 14 commercial laboratory hCG tests, 3 appropriately detected hyperglycosylated hCG standard. Of 18 different home pregnancy products 11 poorly or very poorly detected this key antigen.


CONCLUSIONS
Hyperglycosylated hCG may be the key molecule in the detection of early pregnancy. However, the majority of tests poorly detected or failed to detect this key antigen. New pregnancy tests are needed that either solely detect hyperglycosylated hCG or equally detect regular hCG and hyperglycosylated hCG.
Cole
Laurence A
LA
USA hCG Reference Service, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA. larry@hcglab.com
Khanlian
Sarah A
SA
Sutton
Jaime M
JM
Davies
Suzy
S
Stephens
Nicole D
ND
D000941:Antigens / Q000652:urine; D045744:Cell Line, Tumor; D006063:Chorionic Gonadotropin / Q000652:urine*; D005260:Female; D006031:Glycosylation; D006801:Humans; D011247:Pregnancy; D011259:Pregnancy Tests, Immunologic / Q000379:methods*; D012680:Sensitivity and Specificity; D014327:Trophoblasts / Q000276:immunology / Q000378:metabolism*
D000941:Antigens; D006063:Chorionic Gonadotropin; C024889:glycosylated HCG