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Human Reproduction, Vol. 12, No. 11, pp. 2538-2541, 1997
© 1997 European Society of Human Reproduction and Embryology

Paired human chorionic gonadotrophin determinations for the prediction of pregnancy outcome in assisted reproduction

Chin-Der Chen, Hong-Nerng Ho1, Ming-Yih Wu, Kuang-Han Chao, Shee-Uan Chen and Yu-Shih Yang

Department of Obstetrics and Gynecology, National Taiwan University Hospital 7 Chung-Shan South Road, Taipei, Taiwan 10016, Republic of China

Correspondence: 1To whom correspondence should be addressed

The aim of this study was to determine the prognostic value of single and paired measurements of serum concentrations of human chorionic gonadotrophin (HCG) for successful pregnancy following in-vitro fertilization (IVF) and tubal embryo transfer (TET). We analysed serum HCG concentrations 15 and 22 days after IVF or TET in 198 conception cycles. Cut-off values of serum HCG were determined by a receiver operating characteristic (ROC) curve. On the basis of single HCG samples on day 15 (HCG15) after transfer, using a cut-off value of HCG15 = 150 mIU/ml, the sensitivity was 71% and the specificity was 77%. The positive predictive value (HCG15 ≥ 150 mIU/ml indicating a normal pregnancy) was 89%, while the negative predictive rate (HCG15 < 150 mIU/ml indicating an abnormal pregnancy) was 51%. Patients with HCG15 < 150 mIU/ml but HCG22/HCG15 ratio ≥ 15, still had a 90% chance of normal pregnancy. However, in patients with HCG15 < 150 mIU/ml and an HCG22/HCG15 ratio <15, there was an 84% chance of an abnormal pregnancy. We conclude that a single HCG15 determination combined with the ratio of HCG22 to HCG15 has a higher diagnostic accuracy for prediction of pregnancy outcome than either analysis alone.

Key words: assisted reproduction/HCG/pregnancy outcome/receiver operating characteristic

Submitted on January 27, 1997; accepted on July 25, 1997.


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