M.P. Leondires

Human chorionic gonadotropin levels after blastocyst transfer are highly predictive of pregnancy outcome.

OBJECTIVEnTo determine the predictive value(s) of beta-hCG serum levels for pregnancy outcome following blastocyst transfer.nnnDESIGNnRetrospective review.nnnSETTINGnUniversity-based assisted reproductive technology (ART) program.nnnPATIENTSnAll ART patients enrolled from January 1998 to December 1999.nnnINTERVENTION(S)nNone.nnnMAIN OUTCOME MEASURE(S)nBeta-hCG serum levels and pregnancy outcomes.nnnRESULT(S)nOf the 836 ART cycles initiated, 608 embryo transfers met study criteria and were assigned to one of two groups: 248 day 5 blastocyst transfers or 360 day 3 embryo transfers. In the day 5 blastocyst group, 147 pregnancies occurred (59.2%), and day 3 transfers resulted in 165 pregnancies (45.8%). For day 3 and day 5 transfers, mean values of beta-hCG on day 16 post-retrieval of spontaneous abortions were lower than ongoing pregnancies (P< .05). A beta-hCG value on day 16 of >300 mIU/mL predicted an ongoing pregnancy for day 5 transfer group in 97% of pregnancies compared with 92% for day 3 embryo transfers. A multiple gestation was observed in 70% of pregnancies with a beta-hCG level >400 mIU/mL in the day 5 group compared with 63% for the day 3 group. The incidence of higher-order multiple gestations was significantly lower in the day 5 blastocyst group (P< .05).nnnCONCLUSION(S)nBeta-hCG serum levels on day 16 post-retrieval were highly predictive of pregnancy outcome after a blastocyst transfer.

A pilot study of cyclosporine for the prevention of postsurgical adhesion formation in rats

OBJECTIVEnOur purpose was to evaluate the efficacy of cyclosporine in preventing primary postsurgical adhesions in the rat model.nnnSTUDY DESIGNnThirty-two Sprague-Dawley rats underwent unilateral uterine horn injury with a combination of unipolar and bipolar cautery. Sixteen of the rats were randomized to the treatment group and received preoperative and daily cyclosporine dosing (10 mg/kg) by gavage for 14 days. At the end of the study all animals were killed, and a standard adhesion scoring system was applied by a blinded examiner.nnnRESULTSnAdhesions were present in 75% of rats in both groups. Treatment did not affect the total adhesion score.nnnCONCLUSIONnCyclosporine does not appear promising as a means to decrease postsurgical adhesion formation.