Serum beta human chorionic gonadotropin levels at 16 days following embryo transfer in intra cytoplasmic sperm injection cycles to predict pregnancy outcome

OBJECTIVE: To determine the prognostic value of beta human chorionic gonadotropin (B-hCG) concentration on the sixteenth day after embryo transfer to predict pregnancy outcome.

METHODS: In this retrospective cohort study, B-hCG levels were measured in 97 pregnant women that underwent intra-cytoplasmic sperm injection (ICSI) in Fatemeh-Zahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran from January 2008 to December 2009. Type, duration, causes of infertility, and age of patients, B-hCG levels on the sixteenth day after embryo transfer, the number of embryos, and pregnancy outcome were assessed.

RESULTS: Incidence of viable pregnancies in B-hCG levels less than 100 IU/L (n=18) was 38.9%, and in B-hCG levels more than or equal to 100 IU/L (n=79) was 84.4%. Correlation of B-hCG with pregnancy outcome was significant (p less than 0.001). Cut-off value of B-hCG to predict viable pregnancy was 100 IU/L (sensitivity - 91%, specificity - 48%, PPV - 85%, and NPV - 61%). The B-hCG levels less than or equal to 200 IU/L with a sensitivity of 88%, specificity of 45%, PPV - 37%, and NPV = 91% had predicted twin pregnancy.

CONCLUSION: Serum B-hCG level on the sixteenth day after embryo transfer can be useful to predict the pregnancy outcome in ICSI cycles.