The Role of Beta hCG Value Measured on the 12th and 14th Days After Embryo Transfer in Determining Early Complications of Pregnancy
Öz
Aim: This study aimed to investigate the role of beta human chorionic gonadotropin (beta hCG) levels on post embryo transfer (ET) 12th- and 14th-day, and its folding after 48 hours in predicting live birth, abortion, and biochemical pregnancy.
Material and Methods: The study included 124 patients who had a positive pregnancy test after a fresh single day 3 ET at the in vitro fertilization (IVF) center between 2017 and 2021. The first beta hCG value was measured 12th day and the second 14th day after ET. The beta hCG fold was calculated by dividing the second beta hCG value by the first beta hCG value.
Results: The patients' IVF indications included unexplained (n=40, 41.1%), poor ovarian reserve (n=23, 25.0%), male factor (n=31, 29.8%), and tubal factor (n=3, 4.1%). Of the 124 patients, 97 (78.2%) had a fetal sac, 81 (63.5%) had a fetal heartbeat (FHB), and 70 (56.5%) had a live birth. The results indicated that the post-ET 14th-day beta hCG level was the best predictor of biochemical pregnancy. It has a high sensitivity (92.5%) and specificity (86.6%), with an optimal cut-off value of 175 U/L. The post-ET 14th-day beta hCG level was the best predictor of a live birth. The post-ET 14th-day beta hCG value of 214.5 U/L had an 82.7% sensitivity and 74.4% specificity to predict the FHB.
Conclusion: The beta hCG value, measured between the 12th and 14th days after ET, as well as the folding rate on these two days, can provide information about the pregnancy progression.
Anahtar Kelimeler
Beta hCG live birth rate post embryo transfer pregnancy outcome
Kaynakça
- Almog B, Al-Shalaty J, Sheizaf B, Shehata F, Son WY, Tan SL, et al. Difference between serum beta-human chorionic gonadotropin levels in pregnancies after in vitro maturation and in vitro fertilization treatments. Fertil Steril. 2011;95(1):85-8.
- Lawler CC, Budrys NM, Rodgers AK, Holden A, Brzyski RG, Schenken RS. Serum beta human chorionic gonadotropin levels can inform outcome counseling after in vitro fertilization. Fertil Steril. 2011;96(2):505-7.
- Deaton JL, Honore GM, Huffman CS, Bauguess P. Early transvaginal ultrasound following an accurately dated pregnancy: the importance of finding a yolk sac or fetal heart motion. Hum Reprod. 1997;12(12):2820-3.
- Zhang Y, Li Z, Ren B, Wu W, Liu Y, Wang X, et al. Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center. Reprod Health. 2022;19(1):145.
- Ozer G. Initial β-hCG levels and 2-day-later increase rates effectively predict pregnancy outcomes in single blastocyst transfer in frozen-thawed or fresh cycles: A retrospective cohort study. Medicine (Baltimore). 2023;102(42):e35605.
- De Neubourg D, Gerris J, Mangelschots K, Van Royen E, Vercruyssen M, Elseviers M. Single top quality embryo transfer as a model for prediction of early pregnancy outcome. Hum Reprod. 2004;19(6):1476-9.
- Zeadna A, Son WY, Moon JH, Dahan MH. A comparison of biochemical pregnancy rates between women who underwent IVF and fertile controls who conceived spontaneously. Hum Reprod. 2015;30(4):783-8.
- Fiddes JC, Goodman HM. Isolation, cloning and sequence analysis of the cDNA for the alpha-subunit of human chorionic gonadotropin. Nature. 1979;281(5730):351-6.
- Wilcox AJ, Weinberg CR, O'Connor JF, Baird DD, Schlatterer JP, Canfield RE, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189-94.
- Shamonki MI, Frattarelli JL, Bergh PA, Scott RT. Logarithmic curves depicting initial level and rise of serum beta human chorionic gonadotropin and live delivery outcomes with in vitro fertilization: an analysis of 6021 pregnancies. Fertil Steril. 2009;91(5):1760-4.
- Dor J, Rudak E, Rotmench S, Levran D, Blankstein J, Lusky A, et al. The role of early post-implantation beta-HCG levels in the outcome of pregnancies following in-vitro fertilization. Hum Reprod. 1988;3(5):663-7.
- Hay DL, Gronow M, Lopata A, Brown JB. Monitoring early production of chorionic gonadotrophin (HCG) following in vitro fertilization and embryo transfer. Aust N Z J Obstet Gynaecol. 1984;24(3):206-9.
- Chen CD, Ho HN, Wu MY, Chao KH, Chen SU, Yang, YS. Paired human chorionic gonadotrophin determinations for the prediction of pregnancy outcome in assisted reproduction. Hum Reprod. 1997;12(11):2538-41.
- Alahakoon TI, Crittenden J, Illingworth P. Value of single and paired serum human chorionic gonadotropin measurements in predicting outcome of in vitro fertilisation pregnancy. Aust N Z J Obstet Gynaecol. 2004:44(1):57-61.
- Poikkeus P, Hiilesmaa V, Tiitinen A. Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Hum Reprod. 2002;17(7):1901-5.
- Bjercke S, Tanbo T, Dale PO, Mørkrid L, Abyholm T. Human chorionic gonadotrophin concentrations in early pregnancy after in-vitro fertilization. Hum Reprod. 1999;14(6):1642-6.
- Qasim SM, Callan C, Choe JK. The predictive value of an initial serum beta human chorionic gonadotropin level for pregnancy outcome following in vitro fertilization. J Assist Reprod Genet. 1996;13(9):705-8.
- Sugantha SE, Webster S, Sundar E, Lenton EA. Predictive value of plasma human chorionic gonadotrophin following assisted conception treatment. Hum Reprod. 2000;15(2):469-73.
- Urbancsek J, Hauzman E, Fedorcsak P, Halmos A, Devenyi N, Papp Z. Serum human chorionic gonadotropin measurements may predict pregnancy outcome and multiple gestation after in vitro fertilization. Fertil Steril. 2002;78(3):540-2.
- Sung N, Kwak-Kim J, Koo HS, Yang KM. Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle. J Assist Reprod Genet. 2016;33(9):1185-94.
- Hughes LM, Schuler A, Sharmuk M, Schauer JM, Pavone ME, Bernardi LA. Early β-hCG levels predict live birth after single embryo transfer. J Assist Reprod Genet. 2022;39(10):2355-64.
- Grin L, Indurski A, Leytes S, Rabinovich M, Friedler S. Trends in primeval β-hCG level increment after fresh and frozen-thawed IVF embryo transfer cycles. Gynecol Endocrinol. 2019;35(3):261-6.
- Kathiresan AS, Cruz-Almeida Y, Barrionuevo MJ, Maxson WS, Hoffman DI, Weitzman VN, et al. Prognostic value of beta-human chorionic gonadotropin is dependent on day of embryo transfer during in vitro fertilization. Fertil Steril. 2011;96(6):1362-6.
Embriyo Transferi Sonrası 12. ve 14. Günlerde Ölçülen Beta hCG Değerinin Gebelikte Erken Komplikasyonların Belirlenmesindeki Rolü
Öz
Amaç: Bu çalışmanın amacı, embriyo transferi (ET) sonrası 12. ve 14. gündeki beta human chorionic gonadotropin (beta hCG) düzeylerinin ve 48 saat sonraki katlanmasının canlı doğum, düşük ve biyokimyasal gebeliği öngörmedeki rolünün araştırılmasıdır.
Gereç ve Yöntemler: Çalışmaya 2017 ve 2021 yılları arasında tüp bebek (in vitro fertilization, IVF) merkezinde taze tek 3. gün ET sonrası gebelik testi pozitif çıkan 124 hasta dahil edildi.
İlk beta hCG değeri ET'den sonra 12. gün, ikincisi ise 14. gün ölçüldü. Beta hCG katlanması, ikinci beta hCG değerinin birinci beta hCG değerine bölünmesiyle hesaplandı.
Bulgular: Hastaların IVF endikasyonları arasında açıklanamayan (n=40, %41,1), kötü over rezervi (n=23, %25,0), erkek faktörü (n=31, %29,8) ve tubal faktör (n=3, %4,1) yer alıyordu. 124 hastanın 97'sinde (%78,2) gebelik kesesi, 81'inde (%63,5) fetal kalp atışı (fetal heartbeat, FHB) ve 70'inde (%56,5) canlı doğum gerçekleşti. Sonuçlar, ET sonrası 14. gün beta hCG düzeyinin biyokimyasal gebeliğin en iyi belirleyicisi olduğunu gösterdi. 175 U/L optimum kesim değeri ile yüksek bir duyarlılığa (%92,5) ve özgüllüğe (%86,6) sahipti. ET sonrası 14. gün beta hCG düzeyi canlı doğumun da en iyi belirleyicisiydi. ET sonrası 14. gün 214,5 U/L beta hCG değerinin FHB'yi öngörmedeki duyarlılığı %82,7, özgüllüğü ise %74,4 idi.
Sonuç: ET sonrası 12. ve 14. günler arasında ölçülen beta hCG değeri ve bu iki gündeki katlanma oranı gebeliğin seyri hakkında bilgi verebilir.
Anahtar Kelimeler
Beta hCG canlı doğum oranı embriyo transferi sonrası gebelik sonucu
Kaynakça
- Almog B, Al-Shalaty J, Sheizaf B, Shehata F, Son WY, Tan SL, et al. Difference between serum beta-human chorionic gonadotropin levels in pregnancies after in vitro maturation and in vitro fertilization treatments. Fertil Steril. 2011;95(1):85-8.
- Lawler CC, Budrys NM, Rodgers AK, Holden A, Brzyski RG, Schenken RS. Serum beta human chorionic gonadotropin levels can inform outcome counseling after in vitro fertilization. Fertil Steril. 2011;96(2):505-7.
- Deaton JL, Honore GM, Huffman CS, Bauguess P. Early transvaginal ultrasound following an accurately dated pregnancy: the importance of finding a yolk sac or fetal heart motion. Hum Reprod. 1997;12(12):2820-3.
- Zhang Y, Li Z, Ren B, Wu W, Liu Y, Wang X, et al. Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center. Reprod Health. 2022;19(1):145.
- Ozer G. Initial β-hCG levels and 2-day-later increase rates effectively predict pregnancy outcomes in single blastocyst transfer in frozen-thawed or fresh cycles: A retrospective cohort study. Medicine (Baltimore). 2023;102(42):e35605.
- De Neubourg D, Gerris J, Mangelschots K, Van Royen E, Vercruyssen M, Elseviers M. Single top quality embryo transfer as a model for prediction of early pregnancy outcome. Hum Reprod. 2004;19(6):1476-9.
- Zeadna A, Son WY, Moon JH, Dahan MH. A comparison of biochemical pregnancy rates between women who underwent IVF and fertile controls who conceived spontaneously. Hum Reprod. 2015;30(4):783-8.
- Fiddes JC, Goodman HM. Isolation, cloning and sequence analysis of the cDNA for the alpha-subunit of human chorionic gonadotropin. Nature. 1979;281(5730):351-6.
- Wilcox AJ, Weinberg CR, O'Connor JF, Baird DD, Schlatterer JP, Canfield RE, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189-94.
- Shamonki MI, Frattarelli JL, Bergh PA, Scott RT. Logarithmic curves depicting initial level and rise of serum beta human chorionic gonadotropin and live delivery outcomes with in vitro fertilization: an analysis of 6021 pregnancies. Fertil Steril. 2009;91(5):1760-4.
- Dor J, Rudak E, Rotmench S, Levran D, Blankstein J, Lusky A, et al. The role of early post-implantation beta-HCG levels in the outcome of pregnancies following in-vitro fertilization. Hum Reprod. 1988;3(5):663-7.
- Hay DL, Gronow M, Lopata A, Brown JB. Monitoring early production of chorionic gonadotrophin (HCG) following in vitro fertilization and embryo transfer. Aust N Z J Obstet Gynaecol. 1984;24(3):206-9.
- Chen CD, Ho HN, Wu MY, Chao KH, Chen SU, Yang, YS. Paired human chorionic gonadotrophin determinations for the prediction of pregnancy outcome in assisted reproduction. Hum Reprod. 1997;12(11):2538-41.
- Alahakoon TI, Crittenden J, Illingworth P. Value of single and paired serum human chorionic gonadotropin measurements in predicting outcome of in vitro fertilisation pregnancy. Aust N Z J Obstet Gynaecol. 2004:44(1):57-61.
- Poikkeus P, Hiilesmaa V, Tiitinen A. Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Hum Reprod. 2002;17(7):1901-5.
- Bjercke S, Tanbo T, Dale PO, Mørkrid L, Abyholm T. Human chorionic gonadotrophin concentrations in early pregnancy after in-vitro fertilization. Hum Reprod. 1999;14(6):1642-6.
- Qasim SM, Callan C, Choe JK. The predictive value of an initial serum beta human chorionic gonadotropin level for pregnancy outcome following in vitro fertilization. J Assist Reprod Genet. 1996;13(9):705-8.
- Sugantha SE, Webster S, Sundar E, Lenton EA. Predictive value of plasma human chorionic gonadotrophin following assisted conception treatment. Hum Reprod. 2000;15(2):469-73.
- Urbancsek J, Hauzman E, Fedorcsak P, Halmos A, Devenyi N, Papp Z. Serum human chorionic gonadotropin measurements may predict pregnancy outcome and multiple gestation after in vitro fertilization. Fertil Steril. 2002;78(3):540-2.
- Sung N, Kwak-Kim J, Koo HS, Yang KM. Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle. J Assist Reprod Genet. 2016;33(9):1185-94.
- Hughes LM, Schuler A, Sharmuk M, Schauer JM, Pavone ME, Bernardi LA. Early β-hCG levels predict live birth after single embryo transfer. J Assist Reprod Genet. 2022;39(10):2355-64.
- Grin L, Indurski A, Leytes S, Rabinovich M, Friedler S. Trends in primeval β-hCG level increment after fresh and frozen-thawed IVF embryo transfer cycles. Gynecol Endocrinol. 2019;35(3):261-6.
- Kathiresan AS, Cruz-Almeida Y, Barrionuevo MJ, Maxson WS, Hoffman DI, Weitzman VN, et al. Prognostic value of beta-human chorionic gonadotropin is dependent on day of embryo transfer during in vitro fertilization. Fertil Steril. 2011;96(6):1362-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kadın Hastalıkları ve Doğum |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 19 Nisan 2024 |
| Yayımlanma Tarihi | 30 Nisan 2024 |
| Gönderilme Tarihi | 29 Kasım 2023 |
| Kabul Tarihi | 4 Nisan 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 26 Sayı: 1 |
Kaynak Göster
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