Utility and Limitations of Human Chorionic Gonadotropin Levels for Remote Follow-up After Medical Management of Early Pregnancy Loss

Roe, Andrea H.; Abernathy, Alice; Flynn, Anne N.; McAllister, Arden; Koelper, Nathanael; Sammel, Mary D.; Schreiber, Courtney A.; Sonalkar, Sarita

doi:10.1097/aog.0000000000004792

Obstetrics &Amp; Gynecology

2022

DOI: 10.1097/aog.0000000000004792

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Utility and Limitations of Human Chorionic Gonadotropin Levels for Remote Follow-up After Medical Management of Early Pregnancy Loss

Andrea H. Roe

Alice Abernathy

Anne N. Flynn

et al.

Abstract: Early pregnancy loss treatment success after medical management was associated with a greater decline in human chorionic gonadotropin (hCG) levels than failure, but an hCG threshold decline to determine treatment success could not be defined.

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Cited by 4 publications

References 12 publications

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Fertility preservation in pregnant cancer patients after first-trimester abortion: a new challenge with possible solutions

Marin,

Ambrosini,

Vio

et al. 2023

J Assist Reprod Genet

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Fertility preservation in pregnant women recently diagnosed with cancer can be a challenge. Raised levels of human chorionic gonadotropin (Beta-hCG) and progesterone in this population of patients may pose a problem for the prompt initiation of controlled ovarian stimulation (COS) due to a potential negative feedback of these hormones on folliculogenesis; however, it is not feasible to wait for negativization of serum beta-hCG levels before starting controlled ovarian stimulation. In literature, very few cases have been reported regarding the preservation of fertility in pregnant women recently diagnosed with cancer. We performed an extended revision of the literature to evaluate the current knowledge of the management of fertility preservation in women with cancer and we examined two cases closely. The first case study involved a cancer patient who underwent surgical abortion at 6.5 weeks of gestation followed by administration of mifepristone to detach any minimal residual trophoblast and consequently to decrease serum beta-hCG and progesterone levels before starting COS. In the second case study, the cancer patient underwent surgical abortion at 7.1 weeks of gestation and simultaneous unilateral oophorectomy for ovarian tissue cryopreservation due to a limited time for COS. By analyzing the results of these studies, it could be hypothesized that mifepristone administration may favor the decrease of serum beta-hCG and progesterone levels in order to permit rapid initiation of COS. In cases where COS is not feasible, ovarian tissue cryopreservation should be considered as an alternative fertility preservation technique.

show abstract

Fertility preservation in pregnant cancer patients after first-trimester abortion: a new challenge with possible solutions

Marin,

Ambrosini,

Vio

et al. 2023

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

Society of Family Planning Clinical Recommendation: Medication management for early pregnancy loss

Tarleton,

Benson,

Moayedi

et al. 2024

Contraception

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Vaginal Bleeding Before 20 Weeks Gestation

Banwarth-Kuhn

McQuade

Krashin

2023

Obstetrics and Gynecology Clinics of North America

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Utility and Limitations of Human Chorionic Gonadotropin Levels for Remote Follow-up After Medical Management of Early Pregnancy Loss

Abstract: Early pregnancy loss treatment success after medical management was associated with a greater decline in human chorionic gonadotropin (hCG) levels than failure, but an hCG threshold decline to determine treatment success could not be defined.

Cited by 4 publications

References 12 publications

Fertility preservation in pregnant cancer patients after first-trimester abortion: a new challenge with possible solutions

Fertility preservation in pregnant cancer patients after first-trimester abortion: a new challenge with possible solutions

Society of Family Planning Clinical Recommendation: Medication management for early pregnancy loss

Vaginal Bleeding Before 20 Weeks Gestation

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