Abstract

This study aimed to assess human chorionic gonadotrophin (hCG) laboratory testing and reporting practices in women with gestational trophoblastic disease (GTD), identifying associated challenges, and exploring views on harmonised hCG testing. An electronic survey, designed by the European Organisation for the Treatment of Trophoblastic Disease (EOTTD) hCG working party, was distributed to member laboratories and scientists involved in GTD management. The survey included five sections: hCG testing methods, quality procedures, result reporting, laboratory operations, and non-GTD testing capabilities. The results revealed significant variability in laboratory practices, even among those using the same testing instruments. Case scenarios highlighted challenges in hCG testing, including the use of inappropriate assays, biotin interference, and the high-dose hook effect. These examples highlight the importance of understanding test limitations. The survey also explored the benefits and challenges of centralised versus non-centralised hCG testing and the use of regression curves for GTD management. Survey limitations included reliance on the EOTTD board for distribution to laboratory contacts and assumptions about respondents' expertise. The findings revealed a lack of harmonisation in hCG testing across laboratories, emphasizing the need for a quality-assured, standardised approach to improve patient care in GTD management.