Kristine Løssl1, Anna Oldenburg2, Mette Toftager1, Jeanette Bogstad1, Lisbeth Praetorius1, Anne Zedeler1, Claus Yding Andersen3, Marie L Grøndahl4, Anja Pinborg1. 1. The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark. 2. Department of Obstetrics & Gynecology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark. 3. Laboratory of Reproductive Biology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 4. The Fertility Clinic, Copenhagen University Hospital Herlev, Copenhagen, Denmark.
Abstract
INTRODUCTION: Prediction of pregnancy outcome after in vitro fertilization is important for patients and clinicians. Early plasma human chorionic gonadotropin (p-hCG) levels are the best known predictor of pregnancy outcome, but no studies have been restricted to single embryo transfer (SET) of Day-2 embryos. The aim of the present study was to investigate the predictive value of p-hCG measured exactly 14 days after the most commonly used Day-2 SET on pregnancy, delivery, and perinatal outcome. MATERIAL AND METHODS: A retrospective analysis of prospectively collected data on 466 women who had p-hCG measured exactly 14 days after Day-2 SET during a randomized trial including 1050 unselected women (aged 18-40 years) undergoing their first in vitro fertilization/ intracytoplasmic sperm injection treatment. RESULTS: The p-hCG predicted clinical pregnancy [area under the curve (AUC) 0.953; 95% CI 0.915-0.992] significantly better than ongoing pregnancy (AUC 0.803, 95% CI 0.717-0.890) and delivery (AUC 0.772, 95% CI 0.691-0.854). Women with p-hCG levels in the lowest quartile had significantly lower clinical pregnancy, ongoing pregnancy, and delivery rates (p < 0.001), whereas the pregnancy outcome and post-clinical pregnancy loss remained similar throughout the three highest p-hCG quartiles. The p-hCG level was related to neither birthweight nor gestational age at delivery. CONCLUSIONS: Clinical pregnancy is significantly better predicted by p-hCG compared with ongoing pregnancy and delivery. Clinical pregnancy rates, ongoing pregnancy rates, and delivery rates remained similar throughout the three highest p-hCG quartiles with no trend towards "the higher the better".
INTRODUCTION: Prediction of pregnancy outcome after in vitro fertilization is important for patients and clinicians. Early plasma human chorionic gonadotropin (p-hCG) levels are the best known predictor of pregnancy outcome, but no studies have been restricted to single embryo transfer (SET) of Day-2 embryos. The aim of the present study was to investigate the predictive value of p-hCG measured exactly 14 days after the most commonly used Day-2 SET on pregnancy, delivery, and perinatal outcome. MATERIAL AND METHODS: A retrospective analysis of prospectively collected data on 466 women who had p-hCG measured exactly 14 days after Day-2 SET during a randomized trial including 1050 unselected women (aged 18-40 years) undergoing their first in vitro fertilization/ intracytoplasmic sperm injection treatment. RESULTS: The p-hCG predicted clinical pregnancy [area under the curve (AUC) 0.953; 95% CI 0.915-0.992] significantly better than ongoing pregnancy (AUC 0.803, 95% CI 0.717-0.890) and delivery (AUC 0.772, 95% CI 0.691-0.854). Women with p-hCG levels in the lowest quartile had significantly lower clinical pregnancy, ongoing pregnancy, and delivery rates (p < 0.001), whereas the pregnancy outcome and post-clinical pregnancy loss remained similar throughout the three highest p-hCG quartiles. The p-hCG level was related to neither birthweight nor gestational age at delivery. CONCLUSIONS: Clinical pregnancy is significantly better predicted by p-hCG compared with ongoing pregnancy and delivery. Clinical pregnancy rates, ongoing pregnancy rates, and delivery rates remained similar throughout the three highest p-hCG quartiles with no trend towards "the higher the better".
Authors: Maria Buhl Borgstrøm; Marie Louise Grøndahl; Tobias W Klausen; Anne K Danielsen; Thordis Thomsen; Ursula Bentin-Ley; Ulla B Knudsen; Steen Laursen; Morten R Petersen; Katrine Haahr; Karsten Petersen; Josephine G Lemmen; Johnny Hindkjær; John Kirk; Jens Fedder; Gitte J Almind; Christina Hnida; Bettina Troest; Betina B Povlsen; Anne Zedeler; Anette Gabrielsen; Thomas Larsen; Ulrik S Kesmodel Journal: PLoS One Date: 2022-07-28 Impact factor: 3.752