Does blastomere biopsy in preimplantation genetic diagnosis affect early serum β-hCG levels?

Cho, Yeon Jean; Kim, Jin Yeong; Song, In Ok; Lee, Hyung Song; Lim, Chun Kyu; Koong, Mi Kyoung; Kang, Inn Soo

doi:10.5653/cerm.2011.38.1.31

Cited by 14 publications

(14 citation statements)

References 18 publications

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“…The differences in hCG-β levels among these studies could be explained by various factors including day of ET, embryo biopsy, method of fertilization, method of freezing and thawing, media of embryo culture and etiology of infertility, etc. [27,[35][36][37]. In our study, hCG-β levels were not affected by the embryonic age or the number of embryos transferred (data not shown).…”

Section: Discussionsupporting

confidence: 42%

“…The cycles resulted in heterotopic pregnancies (both extrauterine and intrauterine pregnancy occur simultaneously, n = 3), or pregnancy losses after >20 weeks gestation (n = 35) were excluded. Pregnancies established with embryos with preimplantation genetic diagnosis (PGD) (n = 101) were also excluded, since PGD has been reported to affect hCG-β level [27]. Pregnancies with incomplete or missing POD 12 or 14 data (n = 664) or missing follow-up during pregnancy (n = 66) were excluded.…”

Section: Study Populationmentioning

confidence: 99%

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Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle

Sung

Kwak‐Kim

Koo

et al. 2016

J Assist Reprod Genet

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Purpose To investigate hCG-β level on postovulatory day (POD) 12 and its fold increase as predictors for pregnancy outcome after in vitro fertilization (IVF) cycles. Methods A retrospective cohort study was performed in total 1408 fresh and 598 frozen cycles between November 2008 and October 2011, which resulted in biochemical pregnancy, early pregnancy loss, or live birth of singleton pregnancy. The serum hCG-β levels of POD 12 and 14 were compared among biochemical pregnancy, early pregnancy loss, and live birth groups. The cutoff values of POD 12 and 14 hCG-β levels and the degree of hCG-β increase from POD 12 to 14 were determined for each pregnancy outcome. Results POD 12 and 14 hCG-β levels stratified based on pregnancy outcomes were significantly different among the biochemical pregnancy, early pregnancy loss, and live birth in both fresh and frozen cycles. Serum hCG-β levels of POD 12 and 14 and the fold increase of hCG-β levels from POD 12 to 14 significantly predict pregnancy outcomes after fresh and frozen cycles. Among these, the cutoff value of POD 14 hCG-β had the highest sensitivity and positive predictive value (PPV). In fresh cycles, the cutoff values of POD 12 and 14 serum hCG-β levels for clinical pregnancies were 30.2 mIU/ mL (sensitivity 81.3 %, specificity 79.6 %, and PPV 92.3 %) and 70.5 mIU/mL (sensitivity 88.4 %, specificity 85.2 %, and PPV 94.7 %). In pregnancies with POD 12 serum hCG-β levels ≥30.2 mIU/mL, the cutoff level of increase of hCG-β for clinical pregnancy was 2.56 (sensitivity 73.6 %, specificity 72.4 %, and PPV 97.8 %). Sequential application of cutoff values such as POD 12 hCG-β and fold increase of hCG-β improved predictability of pregnancy outcome as compared with that of POD 12 hCG-β alone. The cutoff values of POD 12 and 14 serum hCG-β levels for live birth were 40.5 mIU/ mL (sensitivity 75.2 %, specificity 72.6 %, PPV 78.9 %) and 104.5 mIU/mL (sensitivity 80.3 %, specificity 74.1 %, PPV 80.8 %). In the frozen cycles, the cutoff values of POD 12 and 14 serum hCG-β level for clinical pregnancy were 31.5 IU/L (sensitivity 80.4 %, specificity 71.1 % and PPV 90 %) and 43.5 mIU/mL (sensitivity 72.6 %, specificity 71.7 %, PPV 77.2 %). In pregnancies with POD 12 serum hCG-β level ≥31.5 mIU/mL, the cutoff value for fold increase of hCG-β was 2.38 for clinical pregnancy (sensitivity 81.6 %, specificity 71.4 % and PPV 87.9 %). The cutoff values of POD 12 and 14 for live birth were 43.5 mIU/mL (sensitivity 72.6 %, specificity 71.7 %, PPV 77.2 %) and 101.6 mIU/mL (sensitivity 79.6 %, specificity 71.1 %, PPV 78.4 %). Sequential application of cutoff values for POD 12 hCG-β level and fold increase of hCG-β significantly increased PPV for live birth but not clinical pregnancy in frozen cycles. Conclusions Early prediction of pregnancy outcome by using POD 12 and 14 cutoff levels and sequential application of cutoff value of fold increase could provide appropriate reference to health care providers to initiate earlier management of Capsule Early prediction of pregnancy outcome...

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Section: Discussionsupporting

confidence: 42%

Section: Study Populationmentioning

confidence: 99%

Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle

Sung

Kwak‐Kim

Koo

et al. 2016

J Assist Reprod Genet

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“…Two groups have demonstrated initial lower β-hCG levels with pregnancies obtained after PGD compared with controls. 40,41 At the same time, the biochemical pregnancy rate, clinical miscarriage rate, and the take-home infant rate were similar in both groups. The lower β-hCG levels may result from the blastomere biopsy, which may decrease the β-hCGproducing activity of the trophoblast, especially at early pregnancy, or a delayed implantation that may occur in biopsied embryos.…”

Section: Is Pgd Safe? Embryo Development Pregnancy Rates and Childrmentioning

confidence: 71%

Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

Tur-Kaspa

2012

Semin Reprod Med

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Patients who undergo in vitro fertilization (IVF) because of preimplantation genetic diagnosis (PGD) require different clinical management than those who come in because of infertility alone. PGD adds a "fourth dimension" to the emotional aspect of a patients' assisted reproductive technology treatment. It significantly decreases the number of embryos available for transfer by 25 to 81%, and therefore ovarian stimulation for IVF with PGD should be tailored individually, taking into account patients' safety and estimated ovarian reserve. Recent studies showed that with increased number of oocytes retrieved, the higher the chance to have an embryo transfer and normal cryopreserved blastocysts. With adequate ovarian stimulation, there is no cutoff for the numbers of oocytes/embryos needed to start PGD with, especially for younger patients. Patient-friendly protocols, such as those based on gonadotropin-releasing hormone antagonist and vaginal progesterone support may be used. Elective single embryo transfer and blastocysts cryopreservation to avoid multiple pregnancies may be offered with PGD. The benefit of adding preimplantation genetic screening to IVF treatment is still controversial, and evidence-based data on 24-chromosome testing of polar bodies or trophectoderm is needed before it may be implemented into routine patient care.This review discusses the clinical management of IVF with PGD based on the best available data and my personal clinical experience as a reproductive specialist with >1000 IVF/intracytoplasmic sperm injection-PGD cycles. The information provided here will assist reproductive specialists, nurses, geneticists, genetic counselors, and embryologists to better counsel and treat couples who wish to conceive with a healthy child through IVF with PGD. It is time for PGD to be viewed as a modern modality of preventive medicine. As such, it should be incorporated into national health-care systems and be covered by medical insurance.

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“…It has been previously demonstrated that in comparison to unbiopsied embryos, the serum ßhCG at the time of pregnancy test is lower in embryos biopsied at the cleavage stage . Furthermore, it has been demonstrated that the age of the woman at the time of the IVF cycle is negatively correlated to the initial serum ßhCG measurement, and that the initial serum ßhCG concentration is higher subsequent to a frozen embryo transfer in comparison to a fresh embryo transfer …”

Section: Discussionmentioning

confidence: 99%

The interval transfer of a frozen‐thawed embryo is more successful than a fresh embryo transfer for women undergoing IVF with recurrent implantation failure after cleavage stage embryo biopsy

Pontré

Ryan

Tan³

et al. 2018

Aust NZ J Obst Gynaeco

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Does blastomere biopsy in preimplantation genetic diagnosis affect early serum β-hCG levels?

Cited by 14 publications

References 18 publications

Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle

Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle

Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

The interval transfer of a frozen‐thawed embryo is more successful than a fresh embryo transfer for women undergoing IVF with recurrent implantation failure after cleavage stage embryo biopsy

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