Serum hCG levels 12 days after embryo transfer is predictive of pregnancy outcome

Abstract

Objective: To determine the predictive value of serum hCG concentrations measured on the twelfth day after embryo transfer (D12) as a marker to distinguish between viable and non-viable pregnancies.Design: Two thousand four hundred six women who had fresh embryo transfers between January 2000 and December 2002 were studied retrospectively. Patients who had serum hCG concentrations higher than 5IU/l on D12 post embryo transfer were stratified and evaluated.Materials and Methods: All women underwent GnRH agonist suppression and controlled ovarian stimulation with gonadotropin administration. Transvaginal follicle aspiration was performed 36 hr after hCG administration and embryo transfers performed on the third post retrieval day. On day 12 following embryo transfer, serum hCG level of each patient was determined by a fluoroimmunometric assay system. Serum hCG values for viable and non-viable pregnancies were compared by Student’s t test.Results: The median hCG concentration was 161.00 IU/l for viable autologous singleton pregnancies. The median hCG concentration in viable multiple pregnancies was 200% higher than in singleton pregnancies with a median value of 321.42 IU/l. Patients with singleton pregnancies that resulted spontaneous abortion (sab) had lower median hCG levels (126.98 IU/l, p<0.01) than viable singleton pregnancies. Multiple pregnancies which resulted in an sab had a median hCG concentration of 196.54 IU/l which was also significantly lower compared to serum hCG concentrations in live multiple birth/ongoing pregnancies. Patients identified as having a biochemical pregnancy were found to have median hCG levels of 36.15 IU/l. Patients with ectopic pregnancies were also associated with low hCG values with the median concentration of 42.56 IU/l.Conclusion: Serum hCG concentration on day 12 following embryo transfer may be a useful prognostic tool in counseling patients regarding pregnancy outcome. Objective: To determine the predictive value of serum hCG concentrations measured on the twelfth day after embryo transfer (D12) as a marker to distinguish between viable and non-viable pregnancies. Design: Two thousand four hundred six women who had fresh embryo transfers between January 2000 and December 2002 were studied retrospectively. Patients who had serum hCG concentrations higher than 5IU/l on D12 post embryo transfer were stratified and evaluated. Materials and Methods: All women underwent GnRH agonist suppression and controlled ovarian stimulation with gonadotropin administration. Transvaginal follicle aspiration was performed 36 hr after hCG administration and embryo transfers performed on the third post retrieval day. On day 12 following embryo transfer, serum hCG level of each patient was determined by a fluoroimmunometric assay system. Serum hCG values for viable and non-viable pregnancies were compared by Student’s t test. Results: The median hCG concentration was 161.00 IU/l for viable autologous singleton pregnancies. The median hCG concentration in viable multiple pregnancies was 200% higher than in singleton pregnancies with a median value of 321.42 IU/l. Patients with singleton pregnancies that resulted spontaneous abortion (sab) had lower median hCG levels (126.98 IU/l, p<0.01) than viable singleton pregnancies. Multiple pregnancies which resulted in an sab had a median hCG concentration of 196.54 IU/l which was also significantly lower compared to serum hCG concentrations in live multiple birth/ongoing pregnancies. Patients identified as having a biochemical pregnancy were found to have median hCG levels of 36.15 IU/l. Patients with ectopic pregnancies were also associated with low hCG values with the median concentration of 42.56 IU/l. Conclusion: Serum hCG concentration on day 12 following embryo transfer may be a useful prognostic tool in counseling patients regarding pregnancy outcome.