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Hum. Reprod. Advance Access published online on November 25, 2005
Human Reproduction, doi:10.1093/humrep/dei389
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received July 29, 2005
Revised September 28, 2005
Accepted September 30, 2005

Article

Defining the rise of serum HCG in viable pregnancies achieved through use of IVF

Karine Chung 1 *, Mary D. Sammel 2, Christos Coutifaris 3, Raffi Chalian 3, Kathleen Lin 3, Arthur J. Castelbaum 4, Martin F. Freedman 4, and Kurt T. Barnhart 1

1 University of Pennsylvania, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, 3701 Market Street, Suite 800, Philadelphia, PA 19104; University of Pennsylvania, Center for Clinical Epidemiology and Biostatistics, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
2 University of Pennsylvania, Center for Clinical Epidemiology and Biostatistics, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
3 University of Pennsylvania, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, 3701 Market Street, Suite 800, Philadelphia, PA 19104
4 Northern Fertility and Reproductive Associates, 1650 Huntingdon Pk, Suite 154, Meadowbrook, PA 19046; Temple University School of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, 3401 N. Broad Street, Philadelphia, PA 19140, USA

* To whom correspondence should be addressed.
Karine Chung, E-mail: karinech{at}usc.edu


  Abstract

BACKGROUND: We aimed to characterize the rate of HCG rise associated with viable IVF pregnancies, and to evaluate the association between HCG rise and potentially influential factors. METHODS: We performed a retrospective cohort analysis of all viable pregnancies achieved through IVF at two centres between January 1999 and March 2004. RESULTS: Of the 455 pregnancies resulting in live births, 391 met inclusion criteria and contributed a total of 1052 HCG values. Using random effects models, the best pattern to describe the rise of log HCG was quadratic with the rate of increase slowing at 24 days post-oocyte retrieval. Limiting the analysis to measurements below the discriminatory zone, the linear model adequately characterized the profile. The average slope was 0.403, yielding a predicted increase of 1.50 (50% increase) in 1 day and 2.24 (124%) in 2 days. In the final model, absolute HCG values, but not rate of rise, were significantly higher for twins and triplets and significantly lower for patients with BMI >30 kg/m2. CONCLUSIONS: The HCG profile of viable pregnancies conceived with IVF is quadratic with an earlier plateau than has been reported for non-IVF pregnancies. The average rate of rise is comparable to previous estimates in symptomatic spontaneous conceptions.

Keywords: body mass index/HCG rise/IVF/multiple pregnancies/viable pregnancies.
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