Anckaert Ellen, Nanos Nikolaos, Schiettecatte Johan, Smitz Johan
Centre for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Reprod Biomed Online. 2005 Aug;11(2):183-8. doi: 10.1016/s1472-6483(10)60956-x.
Serum human chorionic gonadotrophin (HCG) in the second and third week after embryo transfer has been used for prediction of pregnancy outcome after assisted reproduction. There are few data on the clinical utility of HCG, progesterone and oestradiol, measured by contemporary immunoassay, in the fourth week after embryo transfer and later. Moreover, large inter-method differences have been described between automated immunoassays, making method-specific cut-off values mandatory. The main aim of this study was to determine assay-specific optimal cut-off values for serum HCG, progesterone and oestradiol for prediction of clinical pregnancy outcome in singleton pregnancies after assisted reproductive techniques, at days 11, 18 and 25 and at week 6 after embryo transfer. A retrospective study was performed on frozen serum samples of 67 singleton pregnancies after assisted reproduction techniques. HCG, oestradiol and progesterone were determined with the automated (random access) VIDAS immunoanalyser. Receiver operating characteristic curve analysis was performed to determine optimal cut-off values. Predictive values were calculated based on the prevalence of non-viable pregnancy after assisted reproduction. It was concluded that measurement of HCG by VIDAS at days 18 and 25, and at week 6 after embryo transfer yields high positive (70.5-100%) and negative (87.2-94.4%) predictive values for clinical pregnancy outcome.
胚胎移植后第二周和第三周的血清人绒毛膜促性腺激素（HCG）已被用于预测辅助生殖后的妊娠结局。关于通过现代免疫测定法在胚胎移植后第四周及更晚时间测量的HCG、孕酮和雌二醇的临床效用的数据很少。此外，自动免疫测定法之间已被描述存在较大的方法间差异，使得特定方法的临界值成为必需。本研究的主要目的是确定在胚胎移植后第11天、18天、25天和第6周时，用于预测辅助生殖技术后单胎妊娠临床妊娠结局的血清HCG、孕酮和雌二醇的特定检测方法的最佳临界值。对67例辅助生殖技术后单胎妊娠的冷冻血清样本进行了一项回顾性研究。使用自动（随机进样）VIDAS免疫分析仪测定HCG、雌二醇和孕酮。进行了受试者工作特征曲线分析以确定最佳临界值。基于辅助生殖后不可行妊娠的患病率计算预测值。得出的结论是，在胚胎移植后第18天和25天以及第6周时，通过VIDAS测量HCG对于临床妊娠结局产生高的阳性（70.5 - 100%）和阴性（87.2 - 94.4%）预测值。
