Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer

Kristine Løssl; Anna Oldenburg; Mette Toftager; Jeanette Bogstad; Lisbeth Prætorius; Anne Zedeler; Claus Yding Andersen; Marie L. Grøndahl; Anja Pinborg

doi:10.1111/aogs.13144

Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer

Kristine Løssl^*, Anna Oldenburg, Mette Toftager, Jeanette Bogstad, Lisbeth Prætorius, Anne Zedeler, Claus Yding Andersen, Marie L. Grøndahl, Anja Pinborg

^*Corresponding author for this work

Department of Clinical Medicine

1 Citation (Scopus)

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”.

Original language	English
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	96
Issue number	8
Pages (from-to)	960-967
Number of pages	8
ISSN	0001-6349
DOIs	https://doi.org/10.1111/aogs.13144
Publication status	Published - 1 Aug 2017

Keywords

Birthweight
gestational age
human chorionic gonadotropin
in vitro fertilization
prediction
pregnancy outcome
receiver operating characteristic

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@article{ead38ba91f3f43eba770528810bd7983,

title = "Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer",

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”.",

keywords = "Birthweight, gestational age, human chorionic gonadotropin, in vitro fertilization, prediction, pregnancy outcome, receiver operating characteristic",

author = "Kristine L{\o}ssl and Anna Oldenburg and Mette Toftager and Jeanette Bogstad and Lisbeth Pr{\ae}torius and Anne Zedeler and {Yding Andersen}, Claus and Gr{\o}ndahl, {Marie L.} and Anja Pinborg",

year = "2017",

month = aug,

day = "1",

doi = "10.1111/aogs.13144",

language = "English",

volume = "96",

pages = "960--967",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

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T1 - Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer

AU - Løssl, Kristine

AU - Oldenburg, Anna

AU - Toftager, Mette

AU - Bogstad, Jeanette

AU - Prætorius, Lisbeth

AU - Zedeler, Anne

AU - Yding Andersen, Claus

AU - Grøndahl, Marie L.

AU - Pinborg, Anja

PY - 2017/8/1

Y1 - 2017/8/1

N2 - 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”.

AB - 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”.

KW - Birthweight

KW - gestational age

KW - human chorionic gonadotropin

KW - in vitro fertilization

KW - prediction

KW - pregnancy outcome

KW - receiver operating characteristic

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U2 - 10.1111/aogs.13144

DO - 10.1111/aogs.13144

M3 - Journal article

C2 - 28374908

AN - SCOPUS:85019386655

SN - 0001-6349

VL - 96

SP - 960

EP - 967

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 8

ER -

Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer

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