The predictive value of discriminatory human chorionic gonadotropin levels in the diagnosis of implantation outcome in in vitro fertilization cycles.
OBJECTIVE
To determine if early serum hCG levels are predictive of implantation outcome in patients undergoing IVF-ET.


METHODS
Retrospective study of IVF cycles using receiver operator characteristic curve (ROC) analysis.


METHODS
Tertiary-care, university hospital-affiliated IVF program.


METHODS
Three hundred fifty-one conception cycles were studied.


METHODS
None.


METHODS
Implantation failure, defined as chemical pregnancies, ectopic gestations, and first trimester abortions, or implantation success, defined as delivered singleton and multiple pregnancies, and second trimester abortions.


RESULTS
For each post-ET day 14 to 20, mean hCG levels of the implantation success group were significantly greater than implantation failure outcomes (P < 0.0001). Using ROC curve analysis, hCG cutoff values for each post-ET day were calculated for optimal discrimination of implantation failure from implantation success cycles. A patient with an hCG measurement greater than the calculated cutoff value had a > or = 90% chance of having an implantation success after IVF-ET.


CONCLUSIONS
Discriminatory hCG cutoff values may be useful in predicting implantation outcome in IVF-ET cycles and may guide clinicians in identifying those pregnancies at risk for adverse outcomes and instituting more intensive surveillance in this population. This information also may be useful in providing counseling to IVF patients regarding pregnancy prognosis and result in cost savings.
Glatstein
I Z
IZ
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Hornstein
M D
MD
Kahana
M J
MJ
Jackson
K V
KV
Friedman
A J
AJ
D006063:Chorionic Gonadotropin / Q000097:blood*; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin