Among the infertility population who using controlled ovarian hyperstimulation(COH), a high percentage of pregnancies results in early pregnancy wastage incidence of multiple pregnancy. So far many investigators have attempted to define clinical
parameters that would differentiate normal pregnancies from abnormal pregnancies at early gestation. Several studies may have suggestion that serial quantitative serum β-human chorionic gonadotropin(β-hCG), pregnancy-specific
glycoprotein(Sp-1),
and
progesterone have significant predictive value as far as pregnancy outcome in COH protocol. However, the data on early prediction in high risk patients are limited, although this information would also be of potential clinical utility.
Between April 1993 and April 1994 of the 78 patients, 94 cycles, who had pregnancy throughout the COH, we had checked serum β-hCG measurement on day 12 after Assisted Reproductive Technology(ART).
So, we conducted to determine the efficacy on predictive indicator and predictive value of single β-hCG on day 12 after ART.
On day 12 after ART, single serum β-hCG level in normal singleton pregnancy, multiple pregnancy and abortion groups were 47.96±33.79, 195.45±122.84 and 19.63±6.29 respectively, which is significant difference each others(p<0.05). In normal
singleton
pregnancy and abortive pregnancy in which serum β-hCG levels were <30mIU/ml, 17 of 18(94.4%) gestations results in abortion, In contrast there were only 1(5.5%) abortive pregnancy with β-hCG levels ≥30mIU/ml(p<0.05) (positive predictive
value=93%).
In normal singleton pregnancies and multple pregnancies in which β-hCG levels were ≥80mIU/ml, 21 of 24(87.5%) gestations results in multiple pregnancies. In contrast, there were only 3 (12.5%) multiple pregnancies with β-CG levels
<80mIU/ml(p<0.05)
(positive predictive value=85%).
In conclusion a single serum β-CG determination on day 12 after ART may discriminate normal singleton, multiple pregnancy or impending miscarriage from normal gestation.
|