Predictive value of serum β-human chorionic gonadotropin for early pregnancy outcomes

  • Zengyan WangEmail author
  • Yong Gao
  • Dan Zhang
  • Yubin Li
  • Lu Luo
  • Yanwen XuEmail author
Gynecologic Endocrinology and Reproductive Medicine



To evaluate the relationship between serum β-human chorionic gonadotropin (HCG) levels and early pregnancy outcomes in women who became pregnant using assisted reproductive technologies (ARTs).


In this study, we retrospectively analyzed 523 pregnancies after ART use, with respect to the early clinical outcomes based on the serum β-HCG levels. The significance of using serum β-HCG levels to predict outcomes in early pregnancy was evaluated by the receiver operating characteristic (ROC) curve and cutoff values of serum β-HCG.


We found that elevated serum β-HCG levels resulted in decreased biochemical pregnancy rates, increased multiple rates, and decreased ongoing and ectopic pregnancy rates. The cutoff values of serum β-HCG levels for the prediction of biochemical pregnancy were 213.15 IU/L, 986.65 IU/L, and 2206.5 IU/L for singletons, multiples, and twins or triplets, respectively.


The serum β-HCG level 14 or 12 days after D3 or D5 embryo transfer (conducted 3 or 5 days after oocyte retrieval), respectively, predicts biochemical/clinical pregnancy and singleton/multiple pregnancy with robust sensitivity and specificity.


Serum β-human chorionic gonadotropin Early pregnancy outcomes Biochemical pregnancy Clinical pregnancy Multiples 


Authors’ contributions

ZY: Project development, data collection, manuscript writing. YG: Data analysis, manuscript editing. DZ: Data collection. YBL: Data collection. LL: Data collection. YWX: Project development, manuscript editing.


This study was supported by the National Natural Science Foundation of China (Grant No’s. 81871110 and 81200473), the Fundamental Research Funds for the Central Universities (Grant No. 18ykpy09), and the Guangdong Provincial Key Laboratory of Reproductive Medicine (Grant No. 2012A061400003).

Compliance with ethical standards

Ethics approval

The institutional ethical board (the First Affiliated Hospital of Sun Yat-sen University) approved this study, and owing to its retrospective nature, informed consent was waived. The authors were blinded to the identity of the individual patients and have no information about the patients corresponding to the data.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Wu G, Yang J, Xu W, Yin T, Zou Y, Wang Y (2014) Serum beta human chorionic gonadotropin levels on day 12 after in vitro fertilization in predicting final type of clinical pregnancy. J Reprod Med 59:161–166. CrossRefPubMedGoogle Scholar
  2. 2.
    Porat S, Savchev S, Bdolah Y, Hurwitz A, Haimov-Kochman R (2007) Early serum β-human chorionic gonadotropin in pregnancies after in vitro fertilization: contribution of treatment variables and prediction of long-term pregnancy outcome. Fertil Steril 88:82–89. CrossRefPubMedGoogle Scholar
  3. 3.
    Oron G, Esh-Broder E, Son WY, Holzer H, Tulandi T (2015) Predictive value of maternal serum human chorionic gonadotropin levels in pregnancies achieved by in vitro fertilization with single cleavage and single blastocyst embryo transfers. Fertil Steril 103:1526–1531. CrossRefPubMedGoogle Scholar
  4. 4.
    Kathiresan AS, Cruz-Almeida Y, Barrionuevo MJ et al (2011) Prognostic value of beta-human chorionic gonadotropin is dependent on day of embryo transfer during in vitro fertilization. Fertil Steril 96:1362–1366. CrossRefPubMedGoogle Scholar
  5. 5.
    Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843. CrossRefPubMedGoogle Scholar
  6. 6.
    Obuchowski N, McClish D (1997) Sample size determination for diagnostic accuracy studies involving binormal ROC curve indices. Stat Med 16:1529–1542.;2-h CrossRefPubMedGoogle Scholar
  7. 7.
    Fournier T, Guibourdenche J, Evain-Brion D (2015) Review: hCGs: different sources of production, different glycoforms and functions. Placenta 36:S60–S65. CrossRefPubMedGoogle Scholar
  8. 8.
    Póvoa A, Severo M, Xavier P, Matias A, Blickstein I (2018) Can early β-human chorionic gonadotropin predict birth of singletons and twins after in vitro fertilization? J Matern Fetal Neonatal Med 31:453–456. CrossRefPubMedGoogle Scholar
  9. 9.
    Urbancsek J, Hauzman E, Fedorcsák P, Halmos A, Dévényi N, Papp Z (2002) Serum human chorionic gonadotropin measurements may predict pregnancy outcome and multiple gestation after in vitro fertilization. Fertil Steril 78:540–542. CrossRefPubMedGoogle Scholar
  10. 10.
    Poikkeus P, Hiilesmaa V, Tiitinen A (2002) Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Hum Reprod 17:1901–1905. CrossRefPubMedGoogle Scholar
  11. 11.
    Lagana AS, Vitale SG, De Dominici R et al (2016) Fertility outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy A 12-years retrospective cohort study. Ann Ital Chir 87:461–465PubMedGoogle Scholar
  12. 12.
    Chen L, Zhu D, Wu Q, Yu Y (2017) Fertility outcomes after laparoscopic salpingectomy or salpingotomy for tubal ectopic pregnancy: a retrospective cohort study of 95 patients. Int J Surg 48:59–63. CrossRefPubMedGoogle Scholar
  13. 13.
    Kim SK, Kim H, Oh S, Lee JR, Jee BC, Kim SH (2018) Development of a novel nomogram for predicting ongoing pregnancy after in vitro fertilization and embryo transfer. Obstet Gynecol Sci 61:669–674. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sung N, Kwak-Kim J, Koo HS, Yang KM (2016) 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 33:1185–1194. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Naredi N, Singh SK, Sharma R (2017) Does first serum beta-human chorionic gonadotropin value prognosticate the early pregnancy outcome in an in vitro fertilisation cycle? J Hum Reprod Sci 10:108–113. CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Morse CB, Barnhart KT, Senapati S et al (2016) Association of the very early rise of human chorionic gonadotropin with adverse outcomes in singleton pregnancies after in vitro fertilization. Fertil Steril 105:1208–1214. CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Singh N, Goyal M, Malhotra N, Tiwari A, Badiger S (2013) Predictive value of early serum beta-human chorionic gonadotrophin for the successful outcome in women undergoing in vitro fertilization. J Hum Reprod Sci 6:245–247. CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Zhao WE, Li YJ, Ou JP, Sun P, Chen WQ, Liang XY (2017) Predictive value of initial serum human chorionic gonadotropin levels for pregnancies after single fresh and frozen blastocyst transfer. J Huazhong Univ Sci Technol Med Sci 37:395–400. CrossRefPubMedGoogle Scholar
  19. 19.
    Zhao YY, Yu Y, Zhang XW (2018) Overall blastocyst quality, trophectoderm grade, and inner cell mass grade predict pregnancy outcome in euploid blastocyst transfer cycles. Chin Med J (Engl) 131:1261–1267. CrossRefGoogle Scholar
  20. 20.
    Padula F, Laganà AS, Vitale SG, D’Emidio L, Coco C, Giannarelli D, Cariola M, Favilli A, Giorlandino C (2017) The introduction of the absolute risk for the detection of fetal aneuploidies in the first-trimester screening. J Matern Fetal Neonatal Med 30:1249–1253. CrossRefPubMedGoogle Scholar
  21. 21.
    Schimmel MS, Bromiker R, Hammerman C et al (2015) The effects of maternal age and parity on maternal and neonatal outcome. Arch Gynecol Obstet 291:793–798. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Reproductive Medicine CenterThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.The Key Laboratory for Reproductive Medicine of Guangdong ProvinceThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina

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