Department of Obstetrics and Gynecology, University of Health Sciences, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.
Center of Assisted Reproduction, University of Health Sciences, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.
Balkan Med J. 2017 Sep 29;34(5):450-457. doi: 10.4274/balkanmedj.2016.1769. Epub 2017 Apr 13.
Several markers were studied previously in order to predict the pregnancy outcome of assisted reproductive techniques; however, serum beta human chorionic gonadotropin was found to be the most predictive marker.
To evaluate the value of serum beta human chorionic gonadotropin levels in discriminating biochemical and clinical pregnancies 12 days after embryo transfer, while determining the factors predicting ongoing pregnancy was established as the secondary aim.
Retrospective cross-sectional study.
A total of 445 pregnant cycles were retrospectively analysed in 2359 embryo transfer cycles. Patients were divided into two groups according to the outcome of pregnancy: biochemical and clinical.
The cut-off value of beta human chorionic gonadotropin levels on day 12 in predicting clinical pregnancies was 86.8 IU/mL with 65.1% sensitivity and 74.7% specificity [CI: 0.76 (0.71-0.81). Receiver operating characteristic curve analysis revealed different cut-off values for embryo transfer days (57 mIU/mL for day 3 embryo transfer CI: 0.59-0.79 and 87 mIU/mL for day 5 embryo transfer, CI: 0.74-0.86). Subgroup analysis of clinical pregnancies revealed a significant difference between ongoing pregnancies and early fetal losses regarding duration of infertility (81.3±54.4 vs. 100.2±62.2 months), serum oestradiol on hCG day (2667.4±1276.4 vs. 2094.6±1260.5 pg/mL), number of transferred embryos (1.9±0.8 vs. 1.5±0.7) and the prevalence of diminished ovarian reserve as an indication (2.3% vs 12.2%).
Beta human chorionic gonadotropin levels on day 12 following embryo transfer provide an important parameter for the prediction of clinical pregnancy; however, other stimulation parameters are indicated in the prediction of ongoing pregnancies.
为了预测辅助生殖技术的妊娠结局，此前研究了多种标志物；然而，人绒毛膜促性腺激素β被发现是最具预测性的标志物。
评估血清β人绒毛膜促性腺激素水平在胚胎移植后 12 天区分生化妊娠和临床妊娠的价值，并确定预测持续妊娠的因素。
回顾性横断面研究。
回顾性分析了 2359 个胚胎移植周期中的 445 个妊娠周期。根据妊娠结局将患者分为生化妊娠组和临床妊娠组。
β人绒毛膜促性腺激素水平在第 12 天预测临床妊娠的截断值为 86.8 IU/mL，其灵敏度为 65.1%，特异性为 74.7%[CI：0.76（0.71-0.81）]。受试者工作特征曲线分析显示，不同的胚胎移植天数有不同的截断值（第 3 天胚胎移植为 57 mIU/mL，CI：0.59-0.79，第 5 天胚胎移植为 87 mIU/mL，CI：0.74-0.86）。临床妊娠的亚组分析显示，持续妊娠和早期胎儿丢失在不孕持续时间（81.3±54.4 与 100.2±62.2 个月）、hCG 日血清雌二醇（2667.4±1276.4 与 2094.6±1260.5 pg/mL）、移植胚胎数量（1.9±0.8 与 1.5±0.7）和卵巢储备减少作为指征的发生率（2.3%与 12.2%）方面存在显著差异。
胚胎移植后第 12 天的β人绒毛膜促性腺激素水平为预测临床妊娠提供了一个重要参数；然而，在预测持续妊娠时需要其他刺激参数。
