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Human Reproduction, Vol. 7, No. 5, pp. 711-717, 1992
© 1992 European Society of Human Reproduction and Embryology

other

The value of serum levels of oestradiol, progesterone and {beta}-human chorionic gonadotrophin in the prediction of early pregnancy loss

Adrian M. Lower1 and John L. Yovich

PIVET Medical Centre 166–168 Cambridge Street, Perth 6007, Western Australia

Correspondence: 1Present address and address for correspondence: Academic Unit of Obstetrics and Gynaecology, The London Hospital Medical College, Whitechapel, London E1, UK

Serial serum levels of oestradiol, progesterone and the {beta}-subunit of human chorionic gonadotrophin ({beta}-HCG) had been performed in 674 cycles in women conceiving a singleton pregnancy, either spontaneously or as a result of assisted conception. To determine the value of these estimations in the prediction of early pregnancy loss, frequency distribution curves and receiver operating characteristic curves were derived for the respective hormones measured at weeks 4–7 of gestation and expressed as multiples of the median (MoM) values in pregnancies occurring both with and without ovarian stimulation. A cut-off level of {beta}-HCG <0.5 MoM gave a sensitivity of 68% with an odds ratio of 4.0 at 7 weeks in unstimulated cycles in the prediction of pregnancy failure. A cut-off of 0.8 MoM for progesterone gave a sensitivity of 59% and an odds ratio of 2.8. Prospective hormonal monitoring during the early weeks of gestation may be useful in the prediction of early pregnancy loss and should help to avoid the emergency presentation of some of the complications of early pregnancy, in particular ectopic pregnancy. The limitations imposed by multiple pregnancies and uncertain gestation due to menstrual data may restrict the use of this strategy to specialist fertility centres.

Key words: assisted reproduction/early pregnancy failure/ectopic pregnancy/spontaneous abortion


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