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Possibility of Live Birth For Patients With Low Serum β-hCG 14 Days After Blastocyst Transfer
Haiying Liu
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Ovarian Research.
Background: Although many previous study investigated the prediction of pregnancy outcomes by serumβ-hCG levels after blastocyst transfer, no study focused on the pregnancy outcomes of patients with initially low serum β-hCG levels. The purpose of the study was to investigate the pregnancy outcomes of patients with low serum β- level 14 days after blastocyst transfer.
Methods: A retrospective study was performed in the Third Affiliated Hospital of Guangzhou Medical University. The purpose was to investigate the patients whose serum β-hCG levels were between 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by chi-squared test. Receiver operating characteristic (ROC) curves were plotted to explore the threshold for prediction of clinical pregnancy and live birth.
Results: A total of 312 patients had serum β-hCG levels <300 mIU/ml 14 days after frozen blastocyst transfer, among which 18.6% were live birth, 47.4% were early miscarriage, 22.8% were biochemical pregnancy and 9.6% were ectopic pregnancy. Pregnancy outcomes were comparable between the patients aged <38 years and ≥38 years. ROC curve analysis showed that the predicted value ofβ-hCG for clinical pregnancy was 58.8 mIU/ml with the AUC of 0.752(95%CI :0.680-0.823), sensitivity of 95.0% and specificity of 53.5%.The threshold for live birth was 108.6mIU/ml with the area under the ROC curve (AUC) of 0.649(95%CI:0.0.583-0.715), sensitivity of 93.1% and specificity of 37.0%.For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with the AUC of 0.899(95%CI :0.801-0.996), sensitivity of 90.3% and specificity of 77.8%; the threshold for live birth was 1.9 with the AUC of 0.808(95%CI :0.724-0.891), sensitivity of 88.5% and specificity of 64.5%.
Conclusions: Initially low serum β-hCG level 14 days after frozen blastocyst transfer indicated minimal likelihood of live birth. For patients having initial β-hCG >58.8 mIU/ml, luteal phase support is suggested to continue. Another serum β-hCG test and ultrasound should be performed one week later. If the initial serum β-hCG is < 58.8 mIU/ml, luteal phase support is suggested to discontinue and measurement of serum β-hCG and ultrasound can be arranged one week later.
Keywords
assisted reproductive technology, human chorionic gonadotropin, pregnancy, live birth, blastocyst
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CURRENT STATUS: Published
Published
On 12 Nov, 2020
Published
On 12 Nov, 2020
No community comments so far
Editorial decision: Accept
On 25 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Reviewer #2 agreed
On 07 Oct, 2020
Review #2 received
Received 07 Oct, 2020
Reviewers invited
Invitations sent on 06 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Editor assigned
On 25 Sep, 2020
Submission checks complete
On 24 Sep, 2020
Editor invited
On 24 Sep, 2020
No comments provided
Review #2 received
Received 31 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Review #1 received
Received 10 Aug, 2020
Reviewer #1 agreed
On 08 Aug, 2020
Reviewers invited
Invitations sent on 05 Aug, 2020
Editor assigned
On 30 Jul, 2020
Submission checks complete
On 29 Jul, 2020
Editor invited
On 29 Jul, 2020
Version 1
Posted 22 May, 2020
No comments provided
Editorial decision: Major revision
On 03 Jul, 2020
Review #2 received
Received 19 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Reviewer #1 agreed
On 10 Jun, 2020
Reviewer #2 agreed
On 10 Jun, 2020
Reviewers invited
Invitations sent on 27 May, 2020
First submitted
On 18 May, 2020
Editor assigned
On 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
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This preprint is under consideration at Journal of Ovarian Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Possibility of Live Birth For Patients With Low Serum β-hCG 14 Days After Blastocyst Transfer
Haiying Liu
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 12 Nov, 2020
Published
On 12 Nov, 2020
No community comments so far
Editorial decision: Accept
On 25 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Reviewer #2 agreed
On 07 Oct, 2020
Review #2 received
Received 07 Oct, 2020
Reviewers invited
Invitations sent on 06 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Editor assigned
On 25 Sep, 2020
Submission checks complete
On 24 Sep, 2020
Editor invited
On 24 Sep, 2020
No comments provided
Review #2 received
Received 31 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Review #1 received
Received 10 Aug, 2020
Reviewer #1 agreed
On 08 Aug, 2020
Reviewers invited
Invitations sent on 05 Aug, 2020
Editor assigned
On 30 Jul, 2020
Submission checks complete
On 29 Jul, 2020
Editor invited
On 29 Jul, 2020
Version 1
Posted 22 May, 2020
No comments provided
Editorial decision: Major revision
On 03 Jul, 2020
Review #2 received
Received 19 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Reviewer #1 agreed
On 10 Jun, 2020
Reviewer #2 agreed
On 10 Jun, 2020
Reviewers invited
Invitations sent on 27 May, 2020
First submitted
On 18 May, 2020
Editor assigned
On 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Ovarian Research.
Background: Although many previous study investigated the prediction of pregnancy outcomes by serumβ-hCG levels after blastocyst transfer, no study focused on the pregnancy outcomes of patients with initially low serum β-hCG levels. The purpose of the study was to investigate the pregnancy outcomes of patients with low serum β- level 14 days after blastocyst transfer.
Methods: A retrospective study was performed in the Third Affiliated Hospital of Guangzhou Medical University. The purpose was to investigate the patients whose serum β-hCG levels were between 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by chi-squared test. Receiver operating characteristic (ROC) curves were plotted to explore the threshold for prediction of clinical pregnancy and live birth.
Results: A total of 312 patients had serum β-hCG levels <300 mIU/ml 14 days after frozen blastocyst transfer, among which 18.6% were live birth, 47.4% were early miscarriage, 22.8% were biochemical pregnancy and 9.6% were ectopic pregnancy. Pregnancy outcomes were comparable between the patients aged <38 years and ≥38 years. ROC curve analysis showed that the predicted value ofβ-hCG for clinical pregnancy was 58.8 mIU/ml with the AUC of 0.752(95%CI :0.680-0.823), sensitivity of 95.0% and specificity of 53.5%.The threshold for live birth was 108.6mIU/ml with the area under the ROC curve (AUC) of 0.649(95%CI:0.0.583-0.715), sensitivity of 93.1% and specificity of 37.0%.For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with the AUC of 0.899(95%CI :0.801-0.996), sensitivity of 90.3% and specificity of 77.8%; the threshold for live birth was 1.9 with the AUC of 0.808(95%CI :0.724-0.891), sensitivity of 88.5% and specificity of 64.5%.
Conclusions: Initially low serum β-hCG level 14 days after frozen blastocyst transfer indicated minimal likelihood of live birth. For patients having initial β-hCG >58.8 mIU/ml, luteal phase support is suggested to continue. Another serum β-hCG test and ultrasound should be performed one week later. If the initial serum β-hCG is < 58.8 mIU/ml, luteal phase support is suggested to discontinue and measurement of serum β-hCG and ultrasound can be arranged one week later.
Figure 1
Figure 2
Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.