Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center

Abstract

Purpose The present study investigated the role of β-hCG in predicting reproductive outcomes and established optimal β-hCG cutoff values in women undergoing cleavage embryo transfer. Methods The patients were transferred with fresh or frozen-thawed embryos and had serum β-hCG levels tested on the 14th day post-embryo transfer. Serum β-hCG levels were compared between different groups. Different cutoff values of β-hCG were established and used to divide the patients into different groups. Reproductive outcomes between groups based on β-hCG levels were compared. Results Significant discrepancies in general characteristics were observed in the subgroups. The cutoff values of β-hCG for predicting the presence/absence of pregnancy, biochemical pregnancy/clinical pregnancy, presence/absence of adverse pregnancy outcomes, and singleton/twin live birth in the cleavage groups were 89.6, 241.1, 585.9, and 981.1 mIU/L, respectively. Biochemical pregnancy rates and adverse pregnancy outcome rates significantly decreased from the low β-hCG group to the higher β-hCG group in sequence. Significantly higher full-term live birth rates were observed in the highest β-hCG group (P < 0.001). Conclusion Serum β-hCG levels were strongly associated with reproductive outcomes. However, the interpretation of β-hCG levels must consider the number and quality of embryos and transfer protocols. When β-hCG was tested on a fixed day post-ET, different cutoff values were required for the prediction of early clinical outcomes. The association between β-hCG and obstetric outcomes must be investigated.

Prognostic value of a serum β-human chorionic gonadotropin cutoff, twelve days after fresh embryo transfer, on predicting live birth among Ugandan women

“…This can be explained by the similar age of utilized oocytes as women older than 40 years are likely to have utilized donor oocytes and oocyte donors are usually younger than 30 years of age. The lack of association between age and serum β-hCG cutoff values is at variance with that reported [49,54] and could have resulted from the small sample size and high proportion of donor oocyte utilization in this population. Serum β-hCG had better discriminatory performance among cycles that utilized autologous oocytes compared with oocyte donor cycles.…”

“…In addition, significant heterogeneity in the interval between embryo transfer and serum β-hCG reading could account for the variation between this study's cutoff and that reported by others. The interval varied by definition, that is, after oocyte retrieval [27,30,47] or after embryo transfer [43,44,46,48,49] . The interval also varied by duration, that is, 14-16 days after oocyte retrieval [27,30,45,47] and 12-16 days after embryo transfer [43,44,46,[48][49][50] .…”

Prognostic value of a serum β-hCG cut off, 12 days after fresh embryo transfer, on predicting live birth among Ugandan women

“…In addition, signi cant heterogeneity in the interval between embryo transfer and serum β-hCG reading, could account for the variation between this study's cut off and that report by others. The interval varied by de nition i.e, after oocyte retrieval [27,44,49] or after embryo transfer [43,45,48,50,51]. The interval also varied by duration i.e, 14-16 days after oocyte retrieval [27,44,47,49] and 12-16 days after embryo transfer [43,45,48,[50][51][52].…”

“…The interval varied by de nition i.e, after oocyte retrieval [27,44,49] or after embryo transfer [43,45,48,50,51]. The interval also varied by duration i.e, 14-16 days after oocyte retrieval [27,44,47,49] and 12-16 days after embryo transfer [43,45,48,[50][51][52].…”

“…Heterogeneity in population characteristics contributed to the disparity in cut off values between this study and others. Some of key characteristics that may have impacted the serum β-hCG cut off include: proportion of multiple gestations [45], embryo grade [56, 58], embryo developmental stage [47], fresh versus frozen embryo transfers [50,56], maternal age [51,56], and the interval between embryo transfer and serum β-hCG reading.…”