M. Shamonki

Logarithmic curves depicting initial level and rise of serum beta human chorionic gonadotropin and live delivery outcomes with in vitro fertilization: An analysis of 6021 pregnancies

OBJECTIVE To correlate the live delivery rate with the initial level and rise of serum beta-hCG. DESIGN Retrospective cohort analysis. SETTING Large private academic center for assisted reproductive technologies and infertility. PATIENT(S) Records of all patients from 1999 to 2005 undergoing IVF with detectable early serum beta-hCG after ET. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Live delivery rate. RESULT(S) Data from 6021 pregnancies were analyzed. Initial beta-hCG was predictive for delivery rate for all patients and for each age group. After controlling for the first beta-hCG, there were higher loss rates as age increased. Percent rise in second beta-hCG drawn 2 days later added predictive value. A decline in beta-hCG almost always resulted in a failure to deliver. There was a progressive increase in delivery rate as the percent rise in beta-hCG went from 0 to 100%; however, there was no further enhancement in delivery rates beyond the 100% rise point. While a better rise in beta-hCG was a good prognostic factor in all age groups, the differences in outcomes for the different age groups remained, even after controlling for first beta-hCG and percent rise. CONCLUSION(S) Initial level and rise in beta-hCG predicts live delivery rate, with oocyte age providing additional predictive value. The established logarithmic curves should provide convenient reference tools for tracking outcomes and counseling patients.