title: Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer.
abstract: BACKGROUND
  Prediction of pregnancy outcome after in vitro fertilization is important for patients and clinicians. Early plasma human chorionic gonadotropin (p-hCG) levels are the best known predictor of pregnancy outcome, but no studies have been restricted to single embryo transfer (SET) of Day-2 embryos. The aim of the present study was to investigate the predictive value of p-hCG measured exactly 14 days after the most commonly used Day-2 SET on pregnancy, delivery, and perinatal outcome.
  
  
  METHODS
  A retrospective analysis of prospectively collected data on 466 women who had p-hCG measured exactly 14 days after Day-2 SET during a randomized trial including 1050 unselected women (aged 18-40 years) undergoing their first in vitro fertilization/ intracytoplasmic sperm injection treatment.
  
  
  RESULTS
  The p-hCG predicted clinical pregnancy [area under the curve (AUC) 0.953; 95% CI 0.915-0.992] significantly better than ongoing pregnancy (AUC 0.803, 95% CI 0.717-0.890) and delivery (AUC 0.772, 95% CI 0.691-0.854). Women with p-hCG levels in the lowest quartile had significantly lower clinical pregnancy, ongoing pregnancy, and delivery rates (p < 0.001), whereas the pregnancy outcome and post-clinical pregnancy loss remained similar throughout the three highest p-hCG quartiles. The p-hCG level was related to neither birthweight nor gestational age at delivery.
  
  
  CONCLUSIONS
  Clinical pregnancy is significantly better predicted by p-hCG compared with ongoing pregnancy and delivery. Clinical pregnancy rates, ongoing pregnancy rates, and delivery rates remained similar throughout the three highest p-hCG quartiles with no trend towards "the higher the better".
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Kristine
authors.identifier: http://orcid.org/0000-0002-4308-3171
authors.initials: K
authors.lastname: Løssl
authors.affiliation: Department of Obstetrics & Gynecology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Anna
authors.initials: A
authors.lastname: Oldenburg
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Toftager
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Bogstad
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Praetorius
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Zedeler
authors.affiliation: Laboratory of Reproductive Biology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Yding Andersen
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Herlev, Copenhagen, Denmark.
authors.forename: Marie L
authors.initials: ML
authors.lastname: Grøndahl
authors.affiliation: The Fertility Clinic, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Pinborg
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human
keywords: Birthweight; gestational age; human chorionic gonadotropin; in vitro fertilization; prediction; pregnancy outcome; receiver operating characteristic