Is there any predictive capability of the first beta-HCG level in in vitro fertilization cycles
Yükleniyor...
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Science Inc
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
OBJECTIVE: Presence of a marker that can predict pregnancy results in in-vitro fertilization cycles and the course of these pregnancies will be a stress mitigating factor for both doctors and the couples receiving treatment. This study was performed to assess whether serum ß-hCG level on the 13th day after embryo transfer (D13 ß-hCG) has a predictive role for different pregnancy results or not. DESIGN: Retrospective cohort study in a single tertiary center. MATERIALS AND METHODS: Two thousand two hundred thirty-six
ICSI cycles were investigated. A total of 616 fresh, non-donor ICSI cycles who met the inclusion criteria were classified into two groups according to D13 ß-hCG; those R10 mIU/mL (pregnant¼251 cases) and those <10 mIU/mL (non pregnant¼365 cases). D13 ß¼hCG after embryo transfer were compared between the two groups and its predictive value for pregnancy outcomes was investigated. Mann-Whitney U test, Kruskal Wallis test, Pearson chi-square and fisher exact test were used, Post Hoc test was
performed. ROC analysis and Spearman correlation were performed. A p value of p<0.05 was considered significant.
RESULTS: Demographic cahracteristics and the number of embryos transferred were similar among groups with and without pregnancy
(p>0.05). Among the 251 cases diagnosed with a pregnancy, 67 had miscarriages (55 early, 12 late). In singleton pregnancies; D13 ß-hCG levels was significantly lower in miscarriage group than ongoing pregnancy group (p<0.05). D13 ß hCG >127mIU/mL was found to predict that pregnancy
will continue >20 weeks with a sensitivity of 83% and a specificity of 66.7% (PPV¼86.3% and NPV¼60%) (95% CI: 68%-84%, p<0,001). D13
ß-hCG <126mIU/mL could predict early miscarriage with 72% sensitivity and 82% spesificity (95% CI: 74%-89%) (p<0,001). D13 ß hCG levels could not predict preterm delivery either in single or multiple pregnancies (p¼0.552 and p¼0.426, respectively), and had no correlation with birth
weight or gestational week at delivery (p¼0.102 and p¼0.571, respectively). CONCLUSIONS: According to this study live births were more frequent in patients with ß hCG >127.5 whereas early pregnancy loss was more likely
below a ß-hCG level of 126.85. Levels above 319.5 could predict multiple pregnancy. No prediction for low birth weight or preterm birth could be made according to the ß hCG level. This is a retrospective analysis. Further prospective studies with more participants are required to predict early pregnancy outcomes in COH cycles.
Açıklama
Anahtar Kelimeler
Fertilization Cycles, Beta-HCG LEVEL, ICSI, ROC Analysis
Kaynak
Fertility And Sterility
WoS Q Değeri
Q1
Scopus Q Değeri
Cilt
106
Sayı
3
