title: Paired human chorionic gonadotrophin determinations for the prediction of pregnancy outcome in assisted reproduction.
abstract: The aim of this study was to determine the prognostic value of single and paired measurements of serum concentrations of human chorionic gonadotrophin (HCG) for successful pregnancy following in-vitro fertilization (IVF) and tubal embryo transfer (TET). We analysed serum HCG concentrations 15 and 22 days after IVF or TET in 198 conception cycles. Cut-off values of serum HCG were determined by a receiver operating characteristic (ROC) curve. On the basis of single HCG samples on day 15 (HCG15) after transfer, using a cut-off value of HCG15 = 150 mIU/ml, the sensitivity was 71% and the specificity was 77%. The positive predictive value (HCG15 > or = 150 mIU/ml indicating a normal pregnancy) was 89%, while the negative predictive rate (HCG15 < 150 mIU/ml indicating an abnormal pregnancy) was 51%. Patients with HCG15 < 150 mIU/ml but HCG22/HCG15 ratio > or = 15, still had a 90% chance of normal pregnancy. However, in patients with HCG15 < 150 mIU/ml and an HCG22/HCG15 ratio < 15, there was an 84% chance of an abnormal pregnancy. We conclude that a single HCG15 determination combined with the ratio of HCG22 to HCG15 has a higher diagnostic accuracy for prediction of pregnancy outcome than either analysis alone.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Republic of China.
authors.forename: C D
authors.initials: CD
authors.lastname: Chen
authors.forename: H N
authors.initials: HN
authors.lastname: Ho
authors.forename: M Y
authors.initials: MY
authors.lastname: Wu
authors.forename: K H
authors.initials: KH
authors.lastname: Chao
authors.forename: S U
authors.initials: SU
authors.lastname: Chen
authors.forename: Y S
authors.initials: YS
authors.lastname: Yang
mesh_terms: D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome
chemical_list: D006063:Chorionic Gonadotropin