Orasanu Bogdan, Jackson Katharine V, Hornstein Mark D, Racowsky Catherine
Department of Obstetrics and Gynecology, ASBI-3, Room 082, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Reprod Biomed Online. 2006 May;12(5):590-8. doi: 10.1016/s1472-6483(10)61185-6.
The hypothesis was tested that the medium used to culture embryos affects the concentration of human chorionic gonadotrophin (HCG) early in pregnancy. The value of these concentrations in predicting successful outcome was also assessed for each medium studied. Patients undergoing IVF between January 1998 and December 2004 and having a day 3 embryo transfer were stratified into one of four groups according to the medium in which their embryos were cultured (P1, IVF500, G1.2, and G1.3). Using receiver operating characteristic (ROC) curve analysis, cut-off values for serum HCG concentrations on day 15 after embryo transfer were calculated for optimal discrimination between cycles resulting in implantation failure and success for each medium. Cut-off points were chosen to maximize sensitivity and specificity. For viable singleton pregnancies, mean HCG concentrations were greater for G1.3 and lower for IVF500 compared with the other media. Discriminatory HCG cut-off concentrations for predicting implantation success were lowest for IVF500, intermediate for P1 and G1.2 and highest for G1.3. The data support the hypothesis that the medium used to culture embryos significantly affects the concentrations of HCG early in pregnancy. Furthermore, when using HCG cut-off concentrations to assess pregnancy outcome, medium type should be taken into consideration.
对用于培养胚胎的培养基是否会影响妊娠早期人绒毛膜促性腺激素（HCG）浓度这一假设进行了检验。对于所研究的每种培养基，还评估了这些浓度在预测成功结局方面的价值。1998年1月至2004年12月期间接受体外受精（IVF）并在第3天进行胚胎移植的患者，根据其胚胎培养所用的培养基（P1、IVF500、G1.2和G1.3）被分为四组之一。使用受试者工作特征（ROC）曲线分析，计算胚胎移植后第15天血清HCG浓度的临界值，以实现对每种培养基导致着床失败和成功的周期进行最佳区分。选择临界值以最大化敏感性和特异性。对于存活的单胎妊娠，与其他培养基相比，G1.3的平均HCG浓度更高，IVF500的平均HCG浓度更低。预测着床成功的鉴别性HCG临界浓度，IVF500最低，P1和G1.2居中，G1.3最高。数据支持以下假设：用于培养胚胎的培养基会显著影响妊娠早期的HCG浓度。此外，在使用HCG临界浓度评估妊娠结局时，应考虑培养基类型。
