Revisiting serum β-hCG cut-off levels and pregnancy outcomes using single embryo transfer
| Autor: | Nabighah Al Zawawi, Ahmed Badeghiesh, Naama Al Mamari, Weon-Young Son, Suhaib Khayat, Michael H. Dahan |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Reproductive medicine Single Embryo Transfer Fertilization in Vitro Biochemical pregnancy 03 medical and health sciences 0302 clinical medicine Pregnancy Genetics Medicine Humans Chorionic Gonadotropin beta Subunit Human Pregnancy outcomes Assisted Reproduction Technologies Genetics (clinical) Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics urogenital system Blastocyst Transfer Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Embryo General Medicine Abortion Spontaneous 030104 developmental biology Reproductive Medicine Female business Live birth Infertility Female Live Birth Developmental Biology |
| Zdroj: | J Assist Reprod Genet |
| ISSN: | 1573-7330 |
| Popis: | PURPOSE: The objective of this study is to identify the pregnancy outcomes based on day-16 β-hCG level assessed with modern assays, in fresh single embryo transfers. METHODS: A retrospective cohort study at a single academic center between 2013 and 2017. A total of 1076 pregnancies were included. RESULTS: Pregnancies were divided into 10% groupings of 107–108 patients each. The 10 groups did not differ for baseline characteristics. There was no difference on outcomes based on cleavage or blastocyst transfer. At a serum β-hCG level of 103 ± 13 (range 74–135), 50% had a biochemical loss. Biochemical pregnancy losses remained 21% at serum β-hCG range (136–197). It was only once serum β-hCG level reached 199–252 that the probability of a biochemical pregnancy loss was 12%. Interestingly, if a clinical pregnancy is present even at low day-16 serum β-hCG levels, the likelihood of live birth is approximately 50%. This maximizes to 75% when the serum β-hCG level was at least 253 IU/L. The relationship between serum day-16 β-hCG levels and clinical pregnancy or live birth is quite strong with correlation coefficients above 0.8 which accounted for more than 75% of the variability in outcomes in both cases. Receiver operator curves determined that the cut-off for a clinical pregnancy was 190 and for live birth, it was 213 IU/L. CONCLUSION: An increase in the serum β-hCG levels at which to expect a reassuring outcome is required based on modern assays, as compared with the old cut-off levels. |
| Databáze: | OpenAIRE |
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