High initial values of β-subunits of human chorionic gonadotropin in ovum donation pregnancies indicate better implantation (original) (raw)
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Journal of assisted reproduction and genetics, 1998
Our purpose was to determine whether there is a correlation between human chorionic gonadotropin (hCG) blood levels and oocyte maturation. Three samples of blood were obtained at different times from hCG administration as follows: 12 hr, 36 hr, during oocyte recovery, and at 84 hr, when the patient comes for embryo transfer. A total of 5036 oocytes was retrieved from 404 patients prospectively recruited between April 1996 and March 1997. The percentage of metaphase-II oocytes at different blood levels ranged from 84 to 88%. The general trend does not show any significant increase in percentage of metaphase-II oocytes in association with an increasing serum hCG concentration. The results of this study suggest that at 12, 36, and 84 hr after hCG administration, levels as low as 50, 45, and 9 IU/L of hCG, respectively, are equally potent as higher levels at initiating maximal oocyte maturity.
Fertility and Sterility
Objective: To determine threshold b-hCG levels predictive of an ongoing pregnancy (OP), live birth (LB), and multiple gestation (MG) in IVF cycles resulting from day-3 (D3) vs. day-5 (D5) embryo transfers (ET), to compare IVF cycle characteristics and pregnancy outcomes in D3 vs. D5 ET groups, and to assess the degree to which maternal characteristics and cycle parameters were predictive of higher b-hCG levels. Design: Retrospective analysis. Setting: Infertility center. Patient(s): Women who had ET performed for IVF cycles between July 2004 and January 2010. Intervention(s): Embryo transfer performed on either D3 or D5 after oocyte fertilization. Main Outcome Measure(s): Beta-hCG on day 15 after oocyte fertilization. Result(s): Beta-hCG levels were significantly higher with D5 ET compared with D3 ETs (D3: 103.6 AE 4.4 IU/L vs. D5: 198.0 AE 10.6 IU/L), and a multivariate analysis demonstrated that D5 ET was a significant predictor of higher b-hCG levels. The b-hCG thresholds predictive of OP were 78 IU/L and 160 IU/L for D3 and D5 ET, which predicted OP in 96% and 91% of cases, respectively. Similarly, for LB, the b-hCG thresholds were 94 IU/L (79% positive predictive value [PPV]) and 160 IU/L (88% PPV), and for MG were 250 IU/L (18% PPV) and 316 IU/L (34% PPV), respectively. Conclusion(s): Initial b-hCG levels are dependent on the day of ET and are a reliable and highly predictive tool for OP outcomes. (Fertil Steril Ò 2011;96:1362-6.
Fertility and Sterility, 2011
Objective: To compare b-hCG levels measured as the first pregnancy test in women who conceived after in vitro maturation (IVM) or IVF. Design: Retrospective matched cohort analysis. Setting: University-based medical center. Patient(s): Women treated with IVM or IVF. Intervention(s): We studied the first serum b-hCG levels in 104 pregnant women who were successfully treated with IVM and in another 104 women with IVF treatment. Blood samplings for b-hCG were drawn on day 12-15 after ET. The two groups were matched by age, order of pregnancy, and day of blood sampling. Main Outcome Measure(s): First b-hCG levels. Result(s): Serum b-hCG levels on days 12 to 13 after ET of IVM viable singleton pregnancies were significantly higher than those of IVF pregnancies (343.2 AE 48.4 vs. 264.0 AE 29.2 IU/L, 95% confidence interval [CI] 22-229). Similarly, b-hCG levels on days 14 to 15 after ET of IVM viable singleton pregnancies were higher than those of IVF pregnancies (350.1 AE 126.4 vs. 284.4 AE 30.2 IU/L). Similar trends were found in b-hCG levels on days 12 to 13 after ET of twin viable pregnancies (IVM, 682.1 AE 97.7 vs. IVF, 434.5 AE 41.8 IU/L; 95% CI 44-662). Grouped linear regression with covariance analysis showed a significant difference between IVM and IVF regression lines. Conclusion(s): The first serum b-hCG levels in pregnancies after IVM are consistently higher than those after IVF treatment. More studies are needed to elucidate these findings. (Fertil Steril Ò 2011;95:85-8.
Research Square (Research Square), 2023
Bolus administration of GnRH analogs mimics physiological ovulation and adding GnRH-a to hCG ("dual triggering") to induce nal oocyte maturation stimulates the luteinizing hormone surge which improves IVF outcomes by decreasing immature oocyte rates. Effects of dual triggering on oocytes have been investigated in previous studies. However, retrieved oocytes in consecutive hCG and dual triggering cycles of poor responder(POR) patients has not been studied yet. In this study, we aimed to examine the retrieved/mature oocyte counts after administering hCG and dual triggering to POR patients in their consecutive IVF cycles. Method A total of 54 patients with two consecutive cycles within two years were included into this single-centered, retrospective cohort study that was conducted at Yeditepe University Hospitals, Istanbul, Turkey, between 2014 and 2021. All patients were diagnosed with POR according to the Bologna Criteria (2011). Dual vs hCG triggering protocols were compared using Wilcoxon test in terms of oocyte count and maturation. Results Although a statistically signi cant difference was observed between the ages of patients in their consecutive IVF cycles, it did not have a clinical signi cance (38.80±3.72 vs 38.17±3.75, p<0.001). Anti mullerian hormone levels and body mass indexes, basal follicle stimulating hormone and estradiol levels were similar between two cycles (p>0.05). No statistically signi cant difference was found in terms of total and mature oocytes between two protocols. Conclusion The results demonstrated that the choice of triggering method, whether hCG or dual triggering, did not signi cantly in uence neither the retrieved oocyte count nor maturation in POR patients.
Fertility and Sterility, 1994
Objective: To assess the effect of an elevated serum P level on the day of heG administration in an IVF cycle on resulting embryos by evaluating their performance at subsequent frozen ET. Design: A retrospective study. Participants: Ninety-six consecutive patients undergoing frozen ET cycles were studied in a tertiary care center. Main Outcome Measures: Serum obtained on the day of heG administration in an IVF cycle was assayed for E2 and P by RIA. The main outcome measured was the development of a clinical pregnancy in a subsequent frozen ET cycle. Results: Using a previously described breakpoint in serum P concentration of 0.9 ng/mL (2.86 nmol/L), 8 of 69 (11.6%) frozen ETs in which embryos from low P level IVF cycles were transferred and 7 of 27 (25.9%) frozen ETs of embryos from elevated P level IVF cycles were transferred resulted in the development of clinical pregnancies. Although this does not clearly demonstrate superiority of embryos obtained from elevated P cycles, employing a power calculation, the probability that the pregnancy rate in the elevated serum P group is at least equal to the observed rate in the low P group is 92.8%. Conclusion: These data suggest that an elevated serum P level on the day of heG administration does not adversely affect the quality of oocytes or resulting embryos.
Human Reproduction, 1995
In a retrospective study of 813 oocyte retrieval-embryo transfer cycles in women with normal follicle stimulating hormone and luteinizing hormone concentrations, we sought to investigate the relationship between the amount of human menopausal gonadotrophin (HMG) used for ovarian stimulation and treatment outcome. Patients were divided into three groups: group A patients (495 cycles) required <40 ampoules of HMG and had a predicted probability for pregnancy of 25% per embryo transfer; group B patients (165 cycles) required 41-77 ampoules per cycle, with a predicted probability rate for pregnancy of 5-25% per embryo transfer; and group C patients (153 cycles) required >77 ampoules of HMG and the predicted probability for pregnancy was <5% per embryo transfer. Groups C and A differed significantly (/» < 0.005). The mean oestradiol concentration on the day of HCG administration in group C was 6412 pmol/l, and the mean number of eggs retrieved was seven. The highest success rates were found when up to 2.5 ampoules of HMG were required for each egg or 4.4 ampoules for each embryo. The lowest rates were obtained when >4.8 ampoules of HMG were necessary for each oocyte or >9.6 ampoules for each embryo (P < 0.005). We identified a group of infertile patients who required excessive amounts of HMG to achieve a fair degree of steroidogenesis, number of eggs and number of embryos but who had very low pregnancy rates. Although all other relevant parameters were normal, this may highlight the beginning of ovarian-gamete insufficiency before the basic hormonal status is affected. In cases of repeated failure, oocyte donation should be considered.
Fertility and Sterility, 2007
Low initial serum beta hCG is a good predictor of early pregnancy failure. We sought to determine the contribution of treatment variables and the predictive value of early serum beta hCG after IVF on long-term pregnancy outcome. A retrospective case-control study. An academic IVF unit. Five hundred thirty-three IVF cycles performed between 1999 and 2004, which resulted in a positive serum beta hCG level (&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 mIU/mL) on day 13 after embryo transfer (ET). The study group included 281 pregnancies with initial beta hCG &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 150 mIU/mL on day 13 after ET. Randomly selected 252 IVF cycles with initial beta hCG &amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 150 mIU/mL comprised the control group. Characteristics of the patients and the treatment protocols were analyzed using logistic regression, Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s chi-square, and Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test. Primary pregnancy outcome was defined as favorable when a fetal pulse was detected, testifying to a viable gestation. Unfavorable outcome referred to chemical or ectopic pregnancies, as well as spontaneous abortions. Additionally, the two groups were followed throughout gestation. Secondary pregnancy outcome was based on the following parameters: gestational age at delivery, method of delivery, and birth weight. Poor primary pregnancy outcome was encountered in 64.8% of the study group and in 22.2% of the control group. Predictors of unfavorable primary pregnancy outcome were older age, use of a short protocol, and shorter than anticipated crown-rump length. No difference was found in the secondary pregnancy outcome between the groups. Preterm labor was more prevalent in the study group, but the difference did not reach statistical significance. Pregnancy viability can be predicted by measuring serum beta hCG as early as on day 13 after ET. Older age, use of a short protocol, and shorter than anticipated crown-rump length are associated with early pregnancy loss. Of those who reach delivery, no significant adverse outcome is anticipated in IVF pregnancies with low initial serum beta hCG.
Fertility and Sterility, 2005
To determine whether the serum concentration of hCG on the day after hCG administration (abbreviated throughout this article as [hCG]) is related to the incidence of ovarian hyperstimulation syndrome (OHSS), oocyte recovery per follicle, fertilization, blastulation, embryo transfer, implantation, and clinical pregnancy. Design: Retrospective study. Setting: Private infertility clinic. Patient(s): The OHSS study group included 849 non-donor IVF cycles performed between with patients younger than 35 years of age. Intervention(s): None. Main Outcome Measure(s): Occurrence of OHSS, severity of OHSS, [hCG], proportion of follicles yielding oocytes, fertilization rate, blastulation rate, transfer rate, implantation rate, and clinical pregnancy rate. Result(s): No significant relationships were observed between [hCG] and the proportion of follicles yielding oocytes, fertilization rate, blastulation rate, or the probabilities of embryo transfer, implantation, or clinical pregnancy. The incidence of OHSS (all types) and OHSS requiring transvaginal paracentesis were predicted by [hCG] (Pϭ.02 and Pϭ.05, respectively) and with follicle count (PϽ.0001 in both cases). Conclusion(s): These results suggest that moderated hCG dosage is useful in preventing OHSS without reducing efficacy. (Fertil Steril 2005;84:93-8.