Prediction of miscarriage in first trimester by serum estradiol, progesterone and β-human chorionic gonadotropin within 9 weeks of gestation

Deng, Wenhui; Sun, Rui; Du, Jun; Wu, Xue; Ma, Lijie; Wang, Min; Lv, Qing

doi:10.1186/s12884-021-04158-w

Cited by 25 publications

(22 citation statements)

References 26 publications

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“…In this study, however, we chose dydrogesterone because it does not contribute to the serum P concentration, which enabled us to evaluate the amount of P absorbed from the vaginal P preparation. 24 This is why we could directly prove that the combined administration of dydrogesterone did not reduce the ongoing pregnancy rate even when the absorption of P from the vagina was insufficient. In addition, dydrogesterone is relatively inexpensive and considered to be reassuring when used during ART or during early pregnancy; therefore, it might be appropriate to administer it in all ART cases employing FET in an HRT cycle.…”

Section: Discussionmentioning

confidence: 96%

The addition of dydrogesterone improves the outcomes of pregnant women with low progesterone levels when receiving vaginal progesterone alone as luteal support in HRT‐FET cycles

Toriumi¹,

Horikawa²,

Sato³

et al. 2023

Reprod Medicine & Biology

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Purpose Vaginal progesterone (VP) alone has been used as luteal support (LS) in HRT‐FET cycles without measuring serum progesterone concentrations (SPC) because it can achieve adequate intrauterine progesterone levels. However, several reports showed that the co‐administration of progestin produced better outcomes than VP alone. We tried to address this discrepancy, focusing on SPC. Methods VP was given to 180 women undergoing HRT‐FET. We measured SPC when pregnancy was diagnosed on day 14 of LS. We compared assisted reproductive technology outcomes between VP alone versus VP + dydrogesterone (D). Results When using VP alone, average SPC in the miscarriage cases (9.6 ng/mL) were significantly lower compared with the ongoing pregnancy (OP) cases (14.7 ng/mL). The cut‐off value for progesterone, 10.7 ng/mL, was a good predictor for the subsequent course of the pregnancy. Of 76 women receiving D ± VP from the start of LS and achieving a pregnancy, the numbers of OP were 44 (84.6%) in SPC ≥ 10.7 ng/mL and 20 (83.3%) in SPC ≤ 10.7 ng/mL with no significant difference. Conclusion VP alone resulted in lower SPC in some pregnant women in HRT‐FET cycles and exhibited a lower OP rate. The co‐administration of D improved an OP rate of low progesterone cases to the level comparable with non‐low progesterone cases.

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Section: Discussionmentioning

confidence: 96%

The addition of dydrogesterone improves the outcomes of pregnant women with low progesterone levels when receiving vaginal progesterone alone as luteal support in HRT‐FET cycles

Toriumi¹,

Horikawa²,

Sato³

et al. 2023

Reprod Medicine & Biology

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“…For β-hCG, it has been broadly accepted that a lower β-hCG level is associated with a poor pregnancy outcome and that the dynamic level of β-hCG may serve better as an indicator, with an increase rate of 66% per 48 h in predicting pregnancy outcome 12 . For E2, Deng et al 13 reported that serum levels of estradiol at 5-6 weeks and 7-9 weeks could identify miscarriage with an area under the ROC curve (AUC) of 0.866 (95% CI 0. 793 ~ 0.938, P = 0.000) and 0.709 (95% CI 0.…”

Section: Discussionmentioning

confidence: 99%

Weekly change in serum β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in women with unexplained recurrent miscarriage

Wang

et al. 2023

Preprint

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Objective To investigate the efficacy of weekly changes in β-human chorionic gonadotropin (β-hCG), estradiol (E2), and progesterone (Prog) levels for pregnancy assessment in patients with unexplained recurrent miscarriage. Methods We included 140 patients with unexplained recurrent miscarriage whose serum β-hCG, E2, and Prog levels were measured three or more times within early pregnancy. The weekly change in serum β-hCG, E2, and Prog levels (Δβ-hCG, ΔE2, and ΔProg) was calculated according to the following formula: [(serum level at third visit) - (serum level at initial visit)]/interval days×7. Participants were divided into two groups according to pregnancy outcomes, which were determined as ongoing pregnancy or miscarriage, at the 20th week of gestation. The Δβ-hCG, ΔE2, and ΔProg levels of the two groups were compared, and the cutoff values of Δβ-hCG, ΔE2, and ΔProg were determined using receiver operating characteristic (ROC) analyses for predicting pregnancy outcome. Results Serum levels of Δβ-hCG identified ongoing pregnancy or miscarriage with an area under the ROC curve (AUC) of 0.841 (95% CI 0.769–0.914), diagnostic cutoff value of 30,632.855 mIU/ml, sensitivity of 0.971, and specificity of 0.642. ΔE2 levels had an AUC of 0.839 (95% CI 0.752–0.926), cutoff value of 45.055 pg/ml, sensitivity of 0.706, and specificity of 0.915. Conclusion Higher increases in the serum levels of Δβ-hCG and ΔE2 are associated with favorable pregnancy outcomes. Weekly remeasurement of serum β-hCG and E2 may be useful for pregnancy risk assessment in patients with unexplained recurrent miscarriage throughout clinical practice.

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“…While in case of viable group 75% of the subjects had levels above 71pg/ml. Many studies have reported the significance of high serum estradiol levels in viable pregnancy 10,11,12 . Aksoy et al reported a cut-off value of 350pg/ml of serum estradiol during first trimester is 80% sensitive and 70% specific for predicting viable pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Serum Estradiol levels during First Trimester of Pregnancy

Khalid¹,

Gill²,

Nazir³

et al. 2022

PJMHS

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Aim: To investigate serum estradiol levels during first trimester. Methods: It was a descriptive, cross-sectional study, conducted on pregnant women between 18 to 35 years of age presenting during first trimester in obstetric unit of a tertiary care hospital in Lahore, Pakistan. Ultrasonography was done to confirm the viability of fetus. 53 women with nonviable pregnancy were included Group 1 and 28 women with viable fetus and no complication were included in Group 2. Those having any systemic illness or history of estrogen intake were excluded. Using aseptic measures, venous blood samples were taken, and serum was separated. Serum estradiol levels were measured by using immunoenzymometric assay (EIA). Median serum Estradiol levels were compared. Receiver operative characteristics (ROC) curve was plotted. Results: Median serum estradiol levels of women with viable pregnancy 150.49 ng/mL (71.01-393.75) were significantly higher than abortion group 9.96ng/mL (2.87-37.7). A cut off value 47.9ng/ml of serum estradiol is 82% sensitive and 81% specific for a viable pregnancy. Conclusion: Optimal serum estradiol levels are necessary for viability of pregnancy. Keywords: Estradiol, pregnancy, abortion, first trimester, early pregnancy failure.

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Prediction of miscarriage in first trimester by serum estradiol, progesterone and β-human chorionic gonadotropin within 9 weeks of gestation

Cited by 25 publications

References 26 publications

The addition of dydrogesterone improves the outcomes of pregnant women with low progesterone levels when receiving vaginal progesterone alone as luteal support in HRT‐FET cycles

The addition of dydrogesterone improves the outcomes of pregnant women with low progesterone levels when receiving vaginal progesterone alone as luteal support in HRT‐FET cycles

Weekly change in serum β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in women with unexplained recurrent miscarriage

Serum Estradiol levels during First Trimester of Pregnancy

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