Predictive value of hCG level 14 days after embryo transfer

Area of Science:

• Reproductive Endocrinology
• Clinical Embryology
• Maternal-Fetal Medicine

Background:

• Quantitative serum human chorionic gonadotropin (hCG) levels 14 days post-embryo transfer (ET) are reportedly linked to pregnancy outcomes and multiple gestation.
• This study aimed to evaluate the predictive capacity of these early hCG levels.

Purpose of the Study:

• To assess the predictive value of serum quantitative hCG levels at 14 days post-ET for pregnancy outcomes.
• To determine the association between 14-day post-ET hCG levels and the likelihood of multiple gestation pregnancies.

Main Methods:

• Prospective study monitoring serum quantitative hCG levels 14 days after in vitro fertilization (IVF) and ET.
• Serial hCG measurements and transvaginal ultrasounds were performed for positive hCG results until fetal cardiac activity was visualized.
• Ongoing pregnancies were defined as those exceeding 20 weeks gestation.

Main Results:

• Eighty-nine of 111 patients (80.2%) with positive 14-day post-ET hCG levels achieved ongoing pregnancies, with a 19.8% spontaneous miscarriage rate.
• Multiple gestation rates varied by hCG level: <300 mIU/mL (9%), 300-600 mIU/mL (40%), and >600 mIU/mL (100%).

Conclusions:

• Serum hCG levels greater than 200 mIU/mL at 14 days post-ET indicate a higher probability of ongoing pregnancies.
• Significantly elevated hCG levels (>600 mIU/mL) at 14 days post-ET strongly predict multiple gestation pregnancies.