Alpha-fetoprotein (AFP) testing measures a protein produced by the fetal liver and yolk during pregnancy, with levels dropping sharply after birth. In healthy adults, AFP levels are very low. Elevated levels occur in two main conditions: first, in certain malignancies, particularly hepatocellular carcinoma (HCC) and germ cell tumors; and second, in the bodily fluids of the pregnant woman or fetus, where abnormally high or low levels may indicate an increased risk of neural tube defects (such as spina bifida) or certain chromosomal disorders in the fetus.