title: Embryonic heart rate as a predictor of first-trimester pregnancy loss in infertility patients after in vitro fertilization.
abstract: OBJECTIVE
  To determine if embryonic heart rate (EHR) is useful to predict first-trimester pregnancy outcome after in vitro fertilization (IVF).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  University-based infertility center.
  
  
  METHODS
  Six hundred fifty patients who completed IVF with singleton implantations from October 2002 to September 2006 were identified.
  
  
  METHODS
  Transvaginal sonography at 4-6 weeks' embryonic age.
  
  
  METHODS
  Embryonic heart rate at 4-6 weeks' embryonic age and first-trimester pregnancy outcome.
  
  
  RESULTS
  Ninety-five patients (14.6%) spontaneously aborted, and 555 (85.4%) patients had clinical pregnancies beyond the first trimester. Groups were similar regarding gravidity, parity, embryos transferred, embryonic age at time of sonogram for EHR, and infertility diagnosis. Mean maternal age was significantly higher in the group that spontaneously aborted. Mean EHR was significantly lower in the group that spontaneously aborted. Multivariate logistic regression confirmed the best predictors of poor pregnancy outcome: increasing maternal age (odds ratio [OR] 1.18) and lower EHR (OR 1.07).
  
  
  CONCLUSIONS
  Embryonic heart rate, independent of maternal age, is useful to help predict first-trimester pregnancy prognosis after IVF. Infertility patients with a low EHR (<or=110 bpm) at 4-6 weeks' embryonic age should be counseled that they are at increased risk for first-trimester pregnancy loss.
authors.affiliation: Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York, New York 10021, USA. err9006@med.cornell.edu
authors.forename: Eden R
authors.initials: ER
authors.lastname: Rauch
authors.forename: Glenn L
authors.initials: GL
authors.lastname: Schattman
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christos
authors.forename: Ty
authors.initials: T
authors.lastname: Chicketano
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011261:Pregnancy Trimester, First; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal