Human chorionic gonadotropin in the context of "Spontaneous abortion"

Implantation, also known as nidation, is the stage in the mammalian embryonic development in which the blastocyst hatches, attaches, adheres, and invades into the endometrium of the female's uterus. Implantation is the first stage of gestation, and, when successful, the female is considered to be pregnant. An implanted embryo is detected by the presence of increased levels of human chorionic gonadotropin (hCG) in a pregnancy test. The implanted embryo will receive oxygen and nutrients in order to grow.

For implantation to take place the uterus must become receptive. Uterine receptivity involves much cross-talk between the embryo and the uterus, initiating changes to the endometrium. This stage gives a synchrony that opens a window of implantation that enables successful implantation of a viable embryo. The endocannabinoid system plays a vital role in this synchrony in the uterus, influencing uterine receptivity, and embryo implantation. The embryo expresses cannabinoid receptors early in its development that are responsive to anandamide (AEA) secreted in the uterus. AEA is produced at higher levels before implantation and is then down-regulated at the time of implantation. This signaling is of importance in the embryo-uterus crosstalk in regulating the timing of embryonic implantation and uterine receptivity. Adequate concentrations of AEA that are neither too high or too low, are needed for successful implantation.

Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. This complication has also been referred to as an extrauterine pregnancy (a.k.a. EUP). Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions, the fetus is unable to survive.

Overall, ectopic pregnancies annually affect less than 2% of pregnancies worldwide. Risk factors for ectopic pregnancy include pelvic inflammatory disease, often due to chlamydia infection; tobacco smoking; endometriosis; prior tubal surgery; a history of infertility; and the use of assisted reproductive technology. Those who have previously had an ectopic pregnancy are at much higher risk of having another one. Most ectopic pregnancies (90%) occur in the fallopian tube, which are known as tubal pregnancies, but implantation can also occur on the cervix, ovaries, caesarean scar, or within the abdomen. Detection of ectopic pregnancy is typically by blood tests for human chorionic gonadotropin (hCG) and ultrasound. This may require testing on more than one occasion. Other causes of similar symptoms include: miscarriage, ovarian torsion, and acute appendicitis.

A pregnancy test is used to determine whether a person is pregnant or not. The two primary methods are testing for the pregnancy hormone (human chorionic gonadotropin (hCG)) in blood or urine using a pregnancy test kit, and scanning with ultrasonography. Testing blood for hCG results in the earliest detection of pregnancy. Almost all pregnant people will have a positive urine pregnancy test one week after the first day of a missed menstrual period.