title: Maternal serum beta-HCG and alpha-fetoprotein concentrations in singleton pregnancies following assisted reproduction.
abstract: BACKGROUND
  The reason for the elevated levels of HCG in assisted reproduction pregnancies remains unknown. Our hypothesis was that this increase is caused by the ovarian superovulation therapy.
  
  
  METHODS
  We compared the beta-HCG and alpha-fetoprotein (AFP) multiples of the median (MoM) in singleton pregnancies after IVF or ICSI with those achieved by frozen embryo transfer (FET) in spontaneous cycles.
  
  
  RESULTS
  The HCG and AFP MoMs (plus minus SEMs) of 59 FET pregnancies were compared with 144 IVF (including 48 ICSI) pregnancies. The maternal HCG of pregnancies following ovarian stimulation was 1.31 plus minus 0.08 MoM compared with 1.35 plus minus 0.12 MoM in the unstimulated ones. The values for AFP were 1.06 plus minus 0.05 versus 1.11 plus minus 0.05 respectively. No significant differences could be observed between pregnancies following stimulated IVF/ICSI and unstimulated FET cycles.
  
  
  CONCLUSIONS
  Our results show that second trimester maternal serum HCG is also elevated in singleton pregnancies following spontaneous FET cycles. The increased maternal serum HCG in IVF pregnancies is thus not related to superovulation therapy. Because of the elevated maternal serum HCG levels, serum screening cannot be performed reliably in pregnancies following assisted reproduction technology. Ultrasonographic detection of the nuchal translucency is unaffected and should be used for this group of women undergoing assisted reproduction.
authors.affiliation: Department of Obstetrics and Gynecology, Department of Clinical Chemistry, P.O. Box 5000, SF-90014, University of Oulu, Finland. antper@utu.fi
authors.forename: A
authors.initials: A
authors.lastname: Perheentupa
authors.forename: A
authors.initials: A
authors.lastname: Ruokonen
authors.forename: L
authors.initials: L
authors.lastname: Tuomivaara
authors.forename: M
authors.initials: M
authors.lastname: Ryynänen
authors.forename: H
authors.initials: H
authors.lastname: Martikainen
mesh_terms: D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D009994:Osmolar Concentration; D010062:Ovulation Induction; D011247:Pregnancy / Q000097:blood*; D012099:Reproductive Techniques; D020554:Sperm Injections, Intracytoplasmic; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins