ACOG Clinical Consensus No. 11: Management of Positive Human Chorionic Gonadotropin Test Results in Nonpregnant Patients Without Gynecologic Malignancy

Positive human chorionic gonadotropin (hCG) test results have been associated with unnecessary workup and treatment, including invasive procedures and chemotherapy. It is important for health care professionals to consider alternative explanations for positive hCG results when pregnancy and malignancy have been excluded, particularly before proceeding with more invasive interventions. Due to the multiple potential etiologies of persistently elevated hCG, health care professionals should evaluate test results according to a systematic framework. When serum hCG test results are elevated, the first steps are to evaluate for pregnancy (both intrauterine and ectopic). Appropriate retesting to rule out various etiologies and to identify the main cause of persistently elevated hCG is necessary to avoid misdiagnosis or mismanagement of elevated hCG levels.