Likelihood of live birth with extremely low β-hCG level 14 days after fresh embryo transfer

Abstract

Objective

To investigate the pregnancy outcomes of patients with low serum β-hCG level 14 days after day 3 embryo transfer.

Methods

A retrospective study was performed with 723 patients with a serum β-hCG level between 5 and 100 mIU/ml 14 days after embryo transfer. Pregnancy outcomes (live birth, clinical pregnancy) were analyzed according to the female patients’ age. ROC curves were plotted to indicate the threshold for prediction of clinical pregnancy and live birth.

Results

Of the 723 patients with serum β-hCG level <100 mIU/mL, 85.6% (619) had biochemical pregnancy, and only 14.4% (104) had clinical pregnancy (including 4.3% with live birth, 3.7% with ectopic pregnancy, and 6.1% with early miscarriage). The rate of live birth was significantly lower in ≥38-year group ,compared with <38-year group (1.3% vs. 5.1%, p = 0.045). The rates of biochemical pregnancy in patients with serum β-hCG of 5–25 mIU/mL and 26–50 mIU/mL were 99.5% and 92.4%, respectively. The serum β-hCG level to predict clinical pregnancy was 44.8 mIU/ml (sensitivity, 90.4%; specificity, 82.1%). For live birth, the serum β-hCG level was 53.7 mIU/ml (sensitivity, 90.3%; specificity, 81.1%).

Conclusions

The likelihood of live birth was minimal with low serum β-hCG level 14 days after embryo transfer.

摘要

目的：研究在Day 3胚胎移植后14天, 血清β-hCG水平低的患者的妊娠结局。方法：回顾性研究了723例胚胎移植后14天的β-hCG水平在5至100 mIU/ml之间的患者。根据女性患者的年龄分析妊娠结局（活产, 临床妊娠）。绘制ROC曲线以指示预测临床妊娠和活产的阈值。结果：在723例血清β-hCG水平<100 mIU/mL的患者中, 生化妊娠的占85.6％（619）, 临床妊娠的只有14.4％（104）（其中活产占4.3％, 异位妊娠占3.7％） , 而早期流产的比例为6.1％）。 ≥38岁年龄组的活产率明显低于38岁年龄组（1.3％比5.1％, p = 0.045）。血清β-hCG分别为5-25 mIU/mL和26-50 mIU/mL的患者的生化妊娠率分别为99.5％和92.4％。预测临床妊娠的血清β-hCG水平为44.8 mIU/ml（敏感性为90.4％；特异性为82.1％）。对于活产, 血清β-hCG水平为53.7 mIU/ml（敏感性为90.3％；特异性为81.1％）。结论：胚胎移植后14天, 血清β-hCG水平低, 活产的可能性很小。

Keywords:

• Assisted reproductive technology
• human chorionic gonadotropin
• pregnancy
• live birth
• embryo transfer

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Natural Science Foundation of China (NO: 81801532); Scientific Research Program of The Third Affiliated Hospital of Guangzhou Medical University (NO:2017Q15).