Human chorionic gonadotrophin concentrations in early pregnancy after in-vitro fertilization

Bjercke, Sverre; Tanbo, Tom; Dale, Per Olav; Mørkrid, Lars; Åbyholm, Thomas

doi:10.1093/humrep/14.6.1642

Cited by 88 publications

(57 citation statements)

References 25 publications

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“…Several studies have reported various cutoff values of initial serum hCG-β levels, drawn a specific number of days after ET to be useful in distinguishing viable with non-viable pregnancies in the early postimplantation period after ART with reasonable sensitivity and specificity [12,[16][17][18][19][20][21][22][23][24][25]. Additionally, serial serum hCG-β levels and the application of established logarithmic curves were reported to offer more reliable results for assessing pregnancy progression [2,21,25].…”

Section: Introductionmentioning

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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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: Introductionmentioning

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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show abstract

“…However, while several studies conclude that a single hormone measurement in early pregnancy can reliably predict pregnancy outcome (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), other reports suggest that serial hormone determinations for differential diagnosis of early pregnancy are superior to single measurements with regard to diagnostic power (15)(16)(17)(18). On the other hand, while most of those previous reports relied on the use of HCG as a single marker in early pregnancy (5)(6)(7)(8)(9)(10)12,14,15,17,18), others investigated also the prognostic value of serum progesterone and estradiol as predictors of early gestational normalcy (11,16,19). Therefore, this study was undertaken to investigate the relative power of HCG, estradiol, and progesterone determinations in the prediction of pregnancy outcome after IVF.…”

Section: Introductionmentioning

confidence: 99%

Early Hormonal Markers of Pregnancy Outcome After In Vitro Fertilization and Embryo Transfer

Carmona

Balasch

Creus

et al. 2003

J Assist Reprod Genet

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Purpose : To investigate the relative power of HCG, estradiol, and progesterone determinations in the prediction of pregnancy outcome after IVF. These prognostic hormonal factors were studied as single and combined predictors. Methods : Serum concentrations of β-HCG, progesterone, and estradiol were measured 12-13 days after embryo transfer (study point 1) and 7 days later (study point 2) in a series of 20 consecutive infertile patients having a first-trimester spontaneous clinical abortion after an IVF-embryo transfer cycle. As a control group (n = 60), the next three IVF-embryo transfer cycles resulting in an ongoing pregnancy after each miscarried IVF cycle in our assisted reproduction program was used. The discrimination attained between the two study groups (ongoing pregnancies and miscarriages) was evaluated by logistic regression and receiver operating characteristic (ROC) curve analysis. Results : Mean hormone concentrations at study points 1 and 2 were higher in the ongoing pregnancy than in the abortion group. Regarding pregnancy outcome the percentage increment of HCG serum levels (≥1321%), with an accuracy (predictive value of pregnancy outcome) of 81.2% (sensitivity 98%, specificity 50%), had the best prognostic reliability but no significant differences were found when this parameter was compared with the predictive value of HCG concentration (≥72 IU/l) at study point 1 (diagnostic accuracy 80.5%; sensitivity 70%; specificity 80%). When ROC analysis was used, the best predictor of ongoing pregnancy according to the AUC ROC was HCG concentration at study point 2 but again no significant differences were found when this parameter was compared with the predictive value of HCG serum levels at study point 1. A multiple marker strategy did not help distinguish viable from nonviable pregnancies. Conclusion : A single, early (days 12-13 after embryo transfer) HCG quantitative serum measurement in IVF cycles not only is diagnostic but also has good predictive value for pregnancy outcome.

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“…The causes of such variation remain largely unknown. The increased hCG concentrations in multiple pregnancies (9) are probably due to the higher number of trophobast cells than in singleton pregnancies. Paracrine and autocrine regulations of hCG synthesis are likely to exist but are poorly understood (4,10).…”

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confidence: 95%

Maternal body mass index and serum concentrations of human chorionic gonadotropin in very early pregnancy

Eskild

Fedorcsák

Mørkrid

et al. 2012

Fertility and Sterility

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Human chorionic gonadotrophin concentrations in early pregnancy after in-vitro fertilization

Cited by 88 publications

References 25 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

Early Hormonal Markers of Pregnancy Outcome After In Vitro Fertilization and Embryo Transfer

Maternal body mass index and serum concentrations of human chorionic gonadotropin in very early pregnancy

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