Chen C D, Ho H N, Wu M Y, Chao K H, Chen S U, Yang Y S
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Republic of China.
Hum Reprod. 1997 Nov;12(11):2538-41. doi: 10.1093/humrep/12.11.2538.
The aim of this study was to determine the prognostic value of single and paired measurements of serum concentrations of human chorionic gonadotrophin (HCG) for successful pregnancy following in-vitro fertilization (IVF) and tubal embryo transfer (TET). We analysed serum HCG concentrations 15 and 22 days after IVF or TET in 198 conception cycles. Cut-off values of serum HCG were determined by a receiver operating characteristic (ROC) curve. On the basis of single HCG samples on day 15 (HCG15) after transfer, using a cut-off value of HCG15 = 150 mIU/ml, the sensitivity was 71% and the specificity was 77%. The positive predictive value (HCG15 > or = 150 mIU/ml indicating a normal pregnancy) was 89%, while the negative predictive rate (HCG15 < 150 mIU/ml indicating an abnormal pregnancy) was 51%. Patients with HCG15 < 150 mIU/ml but HCG22/HCG15 ratio > or = 15, still had a 90% chance of normal pregnancy. However, in patients with HCG15 < 150 mIU/ml and an HCG22/HCG15 ratio < 15, there was an 84% chance of an abnormal pregnancy. We conclude that a single HCG15 determination combined with the ratio of HCG22 to HCG15 has a higher diagnostic accuracy for prediction of pregnancy outcome than either analysis alone.
本研究的目的是确定人绒毛膜促性腺激素（HCG）血清浓度的单次及配对测量对于体外受精（IVF）和输卵管胚胎移植（TET）后成功妊娠的预后价值。我们分析了198个妊娠周期中IVF或TET后15天和22天的血清HCG浓度。血清HCG的临界值通过受试者工作特征（ROC）曲线确定。根据移植后第15天的单次HCG样本（HCG15），使用临界值HCG15 = 150 mIU/ml，敏感性为71%，特异性为77%。阳性预测值（HCG15≥150 mIU/ml表明妊娠正常）为89%，而阴性预测率（HCG15＜150 mIU/ml表明妊娠异常）为51%。HCG15＜150 mIU/ml但HCG22/HCG15比值≥15的患者，仍有90%的机会妊娠正常。然而，HCG15＜150 mIU/ml且HCG22/HCG15比值＜15的患者，妊娠异常的几率为84%。我们得出结论，单次HCG15测定结合HCG22与HCG15的比值对妊娠结局的预测比单独的任何一种分析具有更高的诊断准确性。
