Human chorionic gonadotropin levels are equally predictive for pregnancy outcome after fresh and vitrified-warmed blastocyst transfer

Abstract

Purpose The aim of the present study was to evaluate if the live birth predictive values of β-hCG levels differ in fresh and vitrified-warmed blastocyst transfer cycles. Methods In the retrospectively designed study, 775 cycles with positive β-hCG values 13 days after fresh blastocyst transfer (fresh ET; n =568) or vitrified-warmed blastocyst transfer (FET; n =207) were selected for analysis. Average β-hCG levels stratified according to pregnancy outcome (biochemical pregnancy, spontaneous abortion, ectopic pregnancy, and singleton or twin birth) were compared between fresh ET and FET cycles. To determine the optimal sensitivity and specificity of β-hCG levels for live birth prediction, a ROC curve was constructed. Fisher's exact test was used to compare the positive predictive values (PPV). Results Average β-hCG levels stratified according to pregnancy outcome were not statistically different between fresh ET and FET cycles. In fresh ET and in FET group, the β-hCG levels were significantly higher in pregnancies resulting in live birth compared to non-viable pregnancies (1,035 vs. 462 IU/L, p < 0.001 and 968 vs. 411 IU/L, p <0.001). Optimal cut-off level for live birth prediction was 495 IU/L (sensitivity 83.0 %, specificity 71.8 %) after ET and 527 IU/L (sensitivity 80.0 % and specificity 76.6 %) after FET. The PPV for live birth rate in the groups after ET and FET were 90.6 % and 84.9 % respectively, without statistically significant difference (p >0.05). Conclusion Beta-hCG levels after fresh and vitrified-warmed blastocyst transfer are equally predictive for pregnancy outcome. Clinicians can be encouraged to interpret β-hCG results in the same manner.

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

“…Our data shows that in both fresh and frozen cycles, the hCG-β levels on POD 12 and 14 were significantly higher in pregnancies resulting in live birth compared to those of non-viable pregnancies such as biochemical or early pregnancy losses, which was consistent with previous studies [31,32]. The proportions of live birth were similar between fresh and frozen cycles; however, the POD 12 and 14 hCG-β levels of frozen cycles were higher in each pregnancy outcome than those of fresh cycles.…”

“…Contradictory to our results, higher hCG-β levels in early pregnancies after fresh cycles as compared to frozen cycles have been previously reported [31]. The other report also demonstrated the mean of hCG-β levels after fresh cycle were higher than after frozen cycles; however, the mean hCG-β levels between these two groups were not significantly different when pregnancies were stratified according to pregnancy outcomes [32]. In our data mean hCG-β levels after frozen cycles were significantly higher than those after fresh cycles regardless of pregnancy outcomes.…”

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

“…Several putative male, female and embryological factors may limit embryo implantation, such as male and female age, and body mass index (BMI), cigarette smoking, thyroid disorder, endometriosis, the presence of fibroids, hydrosalpinges, metabolic disorder, a thrombophilia, high sperm DNA fragmentation, and the quality and chromosomal status of embryos transferred …”

Hyperglycosylated human chorionic gonadotropin as a predictor of ongoing pregnancy

“…[20][21][22] Likely contributing to this, several clinical factors are associated with lower absolute hCG values in ongoing pregnancies, including day of embryo transfer (cleavage-stage vs blastocyst transfer), singleton vs multiple pregnancy, and body mass index (<30 kg/m 2 as compared to BMI>30 kg/m 2 ). [23][24][25][26] hCG-H has been explored to a limited extent as a marker of early pregnancy prognosis, although prior studies have several limitations: patient sample sizes have been small; transfers of multiple embryos have been included (which may result in multiple implantations that affect hCG levels); and embryos at different stages (cleavage-stage and blastocyst) have been included, whereas thawed embryos have been excluded, despite increasing use of cryo-embryo transfers due to excellent survival rates achieved with vitrification. [27][28][29][30] Furthermore, these prior studies did not consistently report or control for demographic and in vitro fertilization (IVF) cycle parameters (such as patient age and embryo quality) that are known to affect pregnancy prognosis.…”