Landmarks during the first forty-two days of gestation demonstrated by the β-subunit of human chorionic gonadotropin and ultrasound

Batzer, Frances R.; Weiner, Stuart; Corson, Stephen L.; Schlaff, Sheldon; Otis, Chari

doi:10.1016/0002-9378(83)90977-8

Cited by 45 publications

(20 citation statements)

References 10 publications

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“…11 Often, the 13-HCG does not reach 6500 miU/ml since those levels in ectopic pregnancies are typically lower than in viable intrauterine pregnancies. 10 In our case, the 13-HCG level was misleading as it was high and doubling time was normal , suggesting a viable intrauterine pregnancy. The normal rise in 13-HCG in our case could be attributed to the fact that the pregnancies were living and/or that two gestations were present.…”

Section: Discussionmentioning

confidence: 59%

Sonographic diagnosis of simultaneous intrauterine and ectopic pregnancy.

Benacerraf¹,

Rinehart²,

Schiff³

1985

Journal of Ultrasound in Medicine

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Section: Discussionmentioning

confidence: 59%

Sonographic diagnosis of simultaneous intrauterine and ectopic pregnancy.

Benacerraf¹,

Rinehart²,

Schiff³

1985

Journal of Ultrasound in Medicine

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“…Similarly, hCG-β cutoff value for ongoing pregnancy on day 15 after oocyte fertilization (POD 15) was reported to be 78 mIU/mL for day 3 ET [35], and hCG-β cutoff on day 14 of ET (POD [17][18][19] for the prediction of pregnancies beyond 12 weeks was reported to be 347 mIU/ ml with 72.2 % sensitivity and 73.6 % specificity [39]. Hence, our data tend to have a compatible POD 12 cutoff value but higher POD 14 cutoff values when considering hCG-β doubling time as 1.4-3.5 days [41,42]. In the present study, the serial hCG-β levels and fold changes were analyzed as predictors for pregnancy outcome.…”

Section: Discussionmentioning

confidence: 73%

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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“…To get around some of these difficulties it has been suggested that serial measurements which allow the rate of increase (or doubling time) of circulating hCG to be determined could be useful. Batzer et al (1981Batzer et al ( , 1983 and Pittaway et al (1985) reported that the rate at which hCG increased could identify women who miscarried subsequently, with a sensitivity of 6&80%, but this was not our experience. Furthermore, Yovich et al (1986) reported 18 anembryonic pregnancies in infertility patients in whom hCG was significantly lower by 4 weeks gestation, but oestradiol and progesterone did not differentiate from normal until 7 weeks; these findings are in direct contrast to our data.…”

Section: Referencesmentioning

confidence: 67%

Some endocrinological events associated with early pregnancy failure

Whittaker

Stewart

Taylor

et al. 1989

BJOG

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Serial measurements of serum progesterone, oestradiol, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 33 women experiencing early pregnancy failure and compared with the values of the same hormones in 72 healthy women having uncomplicated pregnancies. Steroid production by the corpus luteum seemed similar in both groups up to 6 weeks gestation but thereafter placental steroidogenesis was not evident in those women in whom spontaneous pregnancy losses occurred. Placental production of the two protein hormones, hCG and hPL, did take place, and whereas the circulating levels were not as high as in normal pregnancies, levels did usually increase before clinical evidence of miscarriage occurred. hCG was not a sensitive discriminator of subsequent failure. In these women there were no significant hormone differences between those with evidence of a fetus and those without.

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Landmarks during the first forty-two days of gestation demonstrated by the β-subunit of human chorionic gonadotropin and ultrasound

Cited by 45 publications

References 10 publications

Sonographic diagnosis of simultaneous intrauterine and ectopic pregnancy.

Sonographic diagnosis of simultaneous intrauterine and ectopic pregnancy.

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

Some endocrinological events associated with early pregnancy failure

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