Rapid, Automated Quantification of Total Human Chorionic Gonadotropin in Serum by a Chemiluminescent Enzyme Immunometric Assay

Total human chorionic gonadotropin (hCG-hCG beta) in serum was assayed with the immulite system, a fully automated random-access immunoassay analyzer that has a unique centrifugal procedure for solid-phase washing and a chemiluminescent detection system. The broad range of the hCG calibration curve (up to 5000 IU/L) is achieved by using a small serum sample size (5 microL), which provides sufficient volume for low-end sensitivity and prevents the possible high-dose hook effect in the working range of the assay. Within-run imprecision (CV) ranged from 3.9% to 5.9% for hCG between 10.5 and 2908 IU/L. Between-run imprecision ranged from 8.8% to 12.7% for hCG mean concentrations from 11.4 to 88.4 IU/L. The antibodies used in the immulite hCG assay system gave little or no interferences when high amounts of follitropin, lutropin, and thyrotropin were added. A complete recognition of the free beta-subunit of hCG was obtained (+/- 180%). In sera from women with molar pregnancies, we observed no high-dose hook effect at hCG concentrations up to 3000 kIU/L. The broad range of hCG concentrations encountered throughout normal pregnancy (up to 200 kIU/L) requires an extended working range to avoid high dilutions. In early pregnancy, accuracy in the range of 1000-5000 IU/L is enhanced by avoiding dilutions.