From the earliest stage of development, the placenta produces hormones, either on its own or in conjunction with the fetus. The very young placental trophoblast produces appreciable amounts of the hormone human chorionic gonadotropin (hCG), which is excreted in the urine. This hormone is not found in the urine of men or of normal, young, non-pregnant women.
Increased urinary hCG levels form the basis of the tests for pregnancy; hCG is present in blood and urine whenever there is living chorionic/placental tissue. hCG is a glycoprotein made up of alpha and beta subunits with 237 amino acids. The beta subunit is the most sensitive and specific test for early pregnancy. hCG can be detected in the urine of pregnant women 26 to 36 days after the first day of the last menstrual period (ie, 5 to 7 days after conception). Pregnancy tests should return to negative 3 to 4 days after delivery.