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Journal of Assisted Reproduction and Genetics

, Volume 30, Issue 11, pp 1459–1463 | Cite as

Human chorionic gonadotropin levels are equally predictive for pregnancy outcome after fresh and vitrified-warmed blastocyst transfer

  • Milan Reljič
  • Jure Knez
  • Veljko Vlaisavljević
Assisted Reproduction Technologies

Abstract

Purpose

The aim of the present study was to evaluate if the live birth predictive values of β-hCG levels differ in fresh and vitrified-warmed blastocyst transfer cycles.

Methods

In the retrospectively designed study, 775 cycles with positive β-hCG values 13 days after fresh blastocyst transfer (fresh ET; n = 568) or vitrified-warmed blastocyst transfer (FET; n = 207) were selected for analysis. Average β-hCG levels stratified according to pregnancy outcome (biochemical pregnancy, spontaneous abortion, ectopic pregnancy, and singleton or twin birth) were compared between fresh ET and FET cycles. To determine the optimal sensitivity and specificity of β-hCG levels for live birth prediction, a ROC curve was constructed. Fisher’s exact test was used to compare the positive predictive values (PPV).

Results

Average β-hCG levels stratified according to pregnancy outcome were not statistically different between fresh ET and FET cycles. In fresh ET and in FET group, the β-hCG levels were significantly higher in pregnancies resulting in live birth compared to non-viable pregnancies (1,035 vs. 462 IU/L, p < 0.001 and 968 vs. 411 IU/L, p < 0.001). Optimal cut-off level for live birth prediction was 495 IU/L (sensitivity 83.0 %, specificity 71.8 %) after ET and 527 IU/L (sensitivity 80.0 % and specificity 76.6 %) after FET. The PPV for live birth rate in the groups after ET and FET were 90.6 % and 84.9 % respectively, without statistically significant difference (p > 0.05).

Conclusion

Beta-hCG levels after fresh and vitrified-warmed blastocyst transfer are equally predictive for pregnancy outcome. Clinicians can be encouraged to interpret β-hCG results in the same manner.

Keywords

Beta-hCG levels Predicting pregnancy outcome Blastocyst transfer Frozen embryo transfer 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    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;96:505–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Ogawa M, Takamatsu K, Horiguchi F. Evaluation of factors associated with the anxiety and depression of female infertility patients. Biopsychosoc Med. 2011;5:15.PubMedCrossRefGoogle Scholar
  3. 3.
    Aarts JW, Huppelschoten AG, van Empel IW. How patient-centered care relates to patients’ quality of life and distress: a study in 427 women experiencing infertility. Hum Reprod. 2012;27:488–95.PubMedCrossRefGoogle Scholar
  4. 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;3:663–7.PubMedGoogle Scholar
  5. 5.
    Ertzeid G, Tanbo T, Dale PO, et al. Human chorionic gonadotropin levels in successful implantations after assisted reproduction techniques. Gynecol Endocrinol. 2000;14:258–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Homan G, Brown S, Moran J, Homan S, Kerin J. Human chorionic gonadotropin as a predictor of outcome in assisted reproductive technology pregnancies. Fertil Steril. 2000;73:270–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Kathiresan ASQ, Cruz-Almeida Y, Barrionuevo MJ, et al. Prognostic value of beta-human chorionic gonadotropin is dependent on day of embryo transfer during in vitro fertilization. Fertil Steril. 2011;96:1362–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Kumbak B. Serum oestradiol and β-hCG measurements after day 3 or 5 embryo transfers in interpreting pregnancy outcome. Reprod Biomed Online. 2006;13:459–64.PubMedCrossRefGoogle Scholar
  9. 9.
    Poikkeus P, Hiilesmaa V, Tiitinen A. Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Hum Reprod. 2002;17:1901–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Sugantha SE, Webster S, Sundar E, Lenton EA. Predictive value of plasma human chorionic gonadotrophin following assisted conception treatment. Hum Reprod. 2000;15:469–73.PubMedCrossRefGoogle Scholar
  11. 11.
    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;78:540–2.PubMedCrossRefGoogle Scholar
  12. 12.
    Zhang X, Barnes R, Confino E, Milad M, Puscheck E, Kazer RR. Delay of embryo transfer to day 5 results in decreased initial serum beta-human chorionic gonadotropin levels. Fertil Steril. 2003;80:1359–63.PubMedCrossRefGoogle Scholar
  13. 13.
    Orasanu B. Effects of culture medium on HCG concentrations and their value in predicting successful IVF outcome. Reprod Biomed Online. 2006;12:590–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Morse CB, Barnhart KT, Sammel MD, Prochaska EC, Dokras A, Coutifaris C. Early rise in hCG as a marker of placentation: a slow rise may predict low birth weight in ART;2011. Oral Presentation, American Society for Reproductive Medicine, Orlando, FL, OctoberGoogle Scholar
  15. 15.
    Vlaisavljević V, Kovačič B, Gavrić-Lovrec V, Reljič M. Simplification of the clinical phase of IVF and ICSI treatment in programmed cycles. Int J Gynaecol Obstet. 2000;69:35–42.Google Scholar
  16. 16.
    Kovačič B, Vlaisavljević V, Reljič M, Čižek-Sajko M. Developmental capacity of different morphological types of day 5 human morulae and blastocysts. Reprod Biomed Online. 2004;8:687–94.PubMedCrossRefGoogle Scholar
  17. 17.
    Kovačič B, Vlaisavljević V. Importance of blastocyst morphology in selection for transfer. In Advances in embryo transfer. Bin Wu, Rijeka, Intech, 2012, 161–77Google Scholar
  18. 18.
    Khalaf Y, El-Toukhy T. The search for a practice model to reduce miscarriage after assisted reproduction. Reprod Biomed Online. 2011;23:695–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Ku PY, Lee RK, Lin SY, Lin MH, Hwu YM. Comparison of the clinical outcomes between fresh blastocyst and vitrified-thawed blastocyst transfer. J Assist Reprod Genet. 2012;29:1353–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Dumoulin JC, Land JA, Van Montfoort AP, Nelissen EC, Coonen E, Derhaag JG, et al. Effect of in vitro culture of human embryos on birthweight of newborns. Hum Reprod. 2010;25:605–12.PubMedCrossRefGoogle Scholar
  21. 21.
    Kolibianakis EM, Venetis CA, Tarlatzis BC. Cryopreservation of human embryos by vitrification or slow freezing: which one is better? Curr Opin Obstet Gynecol. 2009;21:270–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Milan Reljič
    • 1
  • Jure Knez
    • 1
  • Veljko Vlaisavljević
    • 1
  1. 1.Department of Reproductive Medicine and Gynaecologic EndocrinologyUniversity Medical Centre MariborMariborSlovenia

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