Abstract

BackgroundAccurately determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes. The variance in ovulation days leads to uncertain accuracy of reference intervals for natural pregnancies. While the gestational age (GA) is accurate estimation during in vitro fertilization-embryo transfer (IVF-ET). Thus, the objective of this research is to construct reference intervals for gestational sac diameter (GSD), yolk sac diameter (YSD), embryonic length (or crown–rump length, CRL) and embryonic heart rate (HR) at 6–10 gestational weeks (GW) after IVF-ET.MethodsFrom January 2010 to December 2016, 30,416 eligible singleton pregnancies were retrospectively recruited. All included participants had full records of early ultrasound measurements and phenotypically normal live neonates after 37 GW, with birth weights > the 5th percentile for gestational age. The curve-fitting method was used to screen the optimal models to predict GSD, CRL, YSD and HR based on gestational days (GD) and GW. Additionally, the percentile method was used to calculate the 5th, 50th, and 95th percentiles.ResultsThere were significant associations among GSD, CRL, YSD, HR and GD and GW, the models were GSD = − 29.180 + 1.070 GD (coefficient of determination [R2] = 0.796), CRL = − 11.960 - 0.147 GD + 0.011 GD2 (R2 = 0.976), YSD = − 2.304 + 0.184 GD - 0.011 GD2 (R2 = 0.500), HR = − 350.410 + 15.398 GD - 0.112 GD2 (R2 = 0.911); and GSD = − 29.180 + 7.492 GW (R2 = 0.796), CRL = − 11.960 - 1.028 GW + 0.535 GW2 (R2 = 0.976), YSD = − 2.304 + 1.288 GW - 0.054 GW2 (R2 = 0.500), HR = − 350.410 + 107.788 GW - 5.488 GW2 (R2 = 0.911), (p < 0.001).ConclusionsReference intervals for GSD, YSD, HR and CRL at 6–10 gestational weeks after IVF-ET were established.

Highlights

  • Determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes

  • Some studies have constructed reference intervals that mostly depend on natural conceptions of women with regular menstrual cycles and known dates of their last menstrual periods (LMPs) [1,2,3]

  • A discrepancy of more than 7 days in gestation calculated by menstrual history and by ultrasound was found in approximately 15% of women with regular menstrual cycles and specific LMP dates due to the variance in ovulation days [4]

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Summary

Introduction

Determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes. Determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes, such as miscarriage. Ultrasound measurements of embryonic and foetal crown–rump length (CRL) are useful to estimate gestational age (GA) in early pregnancy [5, 6], and the classic Robinson curve is the most common method [7]. Some researchers have shown that there is generalized underestimation of GA by the Robinson curve [8, 9] These findings have led to uncertain accuracy of reference intervals for natural pregnancies

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