Laboratory methods for evaluating early pregnancy loss in an industry-based population

Area of Science:

• Reproductive Endocrinology
• Biomarker Analysis
• Occupational Health

Background:

• Analyzing large volumes of daily urine samples presents logistical challenges.
• Accurate detection of early pregnancy and fetal loss is crucial for reproductive health studies.

Purpose of the Study:

• To develop and validate efficient laboratory methods for analyzing daily urine samples.
• To assess the effectiveness of screening assays for human chorionic gonadotropin (hCG) in identifying conception and early fetal loss.
• To evaluate the utility of multiple urinary biomarkers in detecting nonconceptive hCG-positive cycles.

Main Methods:

• Adapted and developed laboratory assays for approximately 70,000 daily urine samples across 2,500+ menstrual cycles.
• Employed an immunoenzymometric assay (IEMA) for initial screening of human chorionic gonadotropin (hCG).
• Confirmed hCG presence using a definitive immunoradiometric assay (IRMA) and analyzed ovarian and pituitary hormones.

Main Results:

• The IEMA screening assay eliminated 78% of cycles, optimizing resource allocation.
• 38 out of 448 cycles were confirmed hCG-positive by IRMA.
• 17 of the 38 hCG-positive cycles were identified as nonconceptive after further evaluation.

Conclusions:

• Screening assays for hCG are effective in optimizing laboratory workflows for large-scale sample analysis.
• Utilizing multiple urinary biomarkers alongside definitive hCG testing is essential for accurately detecting early fetal loss.
• This approach enhances the understanding of reproductive events in women working in the semiconductor industry.