Maternal serum vascular endothelial growth factor levels in early ectopic and intrauterine pregnancies after in vitro fertilization treatment.
OBJECTIVE
To determine whether serum levels of vascular endothelial growth factor (VEGF) 11 days after a day-3 embryo transfer were predictive of outcome, in women with normal intrauterine pregnancy (IUP), first-trimester miscarriage (SAB), biochemical (BC), and ectopic pregnancy (EP) after IVF therapy.


METHODS
Retrospective analysis.


METHODS
University hospital IVF unit.


METHODS
One hundred eight women who underwent IVF therapy and who were subsequently diagnosed with EP, BC, SAB, or a normal IUP (27 in each category).


METHODS
Serum samples were obtained at 11 days after a day-3 embryo transfer.


METHODS
Serum concentrations of VEGF, P, and beta-hCG.


RESULTS
Serum concentrations of VEGF were similar in women with BC and EP and higher than in women with normal IUP and SAB (571.8 +/- 61.8, 604.4 +/- 73.4 vs. 448.9 +/- 39.9, 461.8 +/- 39.2 pg/mL, respectively). Also, serum beta-hCG and P levels were significantly higher in women with a normal IUP and SAB. Using a cutoff concentration of >700 pg/mL for VEGF, an EP could be distinguished from an IUP (normal and SAB), with a positive predictive value of 64% and a negative predictive value of 71%.


CONCLUSIONS
Elevated maternal serum levels of VEGF, as early as 11 days after embryo transfer, are associated with ectopic pregnancies after IVF.
Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, 305 East 70th Street, New York, NY 10021, USA.
Sozos J
SJ
Fasouliotis
Steven D
SD
Spandorfer
Steven S
SS
Witkin
Hung-Ching
HC
Liu
Jeffrey E
JE
Roberts
Zev
Z
Rosenwaks
D000022:Abortion, Spontaneous / Q000097:blood; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D009865:Oocytes / Q000166:cytology; D011247:Pregnancy / Q000097:blood*; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000097:blood*; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
D018997:Chorionic Gonadotropin, beta Subunit, Human; D042461:Vascular Endothelial Growth Factor A; D011374:Progesterone