title: Defining the rise of serum HCG in viable pregnancies achieved through use of IVF.
abstract: BACKGROUND
  We aimed to characterize the rate of HCG rise associated with viable IVF pregnancies, and to evaluate the association between HCG rise and potentially influential factors.
  
  
  METHODS
  We performed a retrospective cohort analysis of all viable pregnancies achieved through IVF at two centres between January 1999 and March 2004.
  
  
  RESULTS
  Of the 455 pregnancies resulting in live births, 391 met inclusion criteria and contributed a total of 1052 HCG values. Using random effects models, the best pattern to describe the rise of log HCG was quadratic with the rate of increase slowing at 24 days post-oocyte retrieval. Limiting the analysis to measurements below the discriminatory zone, the linear model adequately characterized the profile. The average slope was 0.403, yielding a predicted increase of 1.50 (50% increase) in 1 day and 2.24 (124%) in 2 days. In the final model, absolute HCG values, but not rate of rise, were significantly higher for twins and triplets and significantly lower for patients with BMI>30 kg/m2.
  
  
  CONCLUSIONS
  The HCG profile of viable pregnancies conceived with IVF is quadratic with an earlier plateau than has been reported for non-IVF pregnancies. The average rate of rise is comparable to previous estimates in symptomatic spontaneous conceptions.
authors.affiliation: University of Pennsylvania, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, 3701 Market Street, Suite 800, Philadelphia, PA 19104, USA. karinech@usc.edu
authors.forename: Karine
authors.initials: K
authors.lastname: Chung
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Christos
authors.initials: C
authors.lastname: Coutifaris
authors.forename: Raffi
authors.initials: R
authors.lastname: Chalian
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lin
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Castelbaum
authors.forename: Martin F
authors.initials: MF
authors.lastname: Freedman
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Barnhart
mesh_terms: D015415:Biomarkers / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin