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• W2516644014 abstract "ObjectiveThe often quoted minimal serum HCG doubling time of early gestations (66% rise in 2 days) is based on a study with an 85% confidence interval in a cohort of only 20 female patients. More recent studies examining HCG dynamics in ART pregnancies are often confounded by multiple embryo transfer, replacement of unscreened embryos, and variation in the day of embryo development and normalization of endometrial transformation. The minimal HCG rise in early pregnancies conceived after single, euploid, frozen-thawed blastocyst transfer (FET) that correlates with good reproductive outcome has yet to be determined.DesignRetrospective cohort analysis.Materials and MethodsPatients that underwent single, euploid FET, from June 2011 to March 2016, were included. Oocyte donor cycles were excluded. Serum HCG levels were monitored on day 9 post FET, and if positive, on day 11. The rise was then correlated with implantation and ongoing pregnancy rates. Data was analyzed by student’s t-test, Chi-square, Kruskal-Wallis, linear and binary logistic regression.ResultsA total of 458 single, euploid FETs were included. HCG rise of ongoing pregnancies (mean: 158.74 ± 57 %; range: 9.5-698.32%) did not differ by maternal age (x2=1.55, p=0.82), BMI (x2=7.13, p=0.13) or blastocyst expansion grade (x2=0.69, p=0.71). The degree of HCG rise significantly correlated to successful implantation (OR 4.101 [95% CI 2.39-7.21], P<0.0001) and ongoing pregnancy (OR 3.51 [95% CI 1.83-6.74], P=0.0002), with a minimal threshold of 10.8% rise conferring a 50% probability of ongoing pregnancy (Table 1). This association was not influenced by maternal age (x2=5.09, p=0.28), BMI (x2=1.78, p=0.78) or blastocyst expansion stage (x2=0.03, p=0.98).ConclusionsTabled 1Modeled probability of ongoing (clinical) pregnancy in relation to 48 hour serum HCG riseProbability of ongoing pregnancyPercent HCG rise over 48 hours50%10.8%75%106.5%80%131.4%90%202.2%95%272.9% Open table in a new tab ObjectiveThe often quoted minimal serum HCG doubling time of early gestations (66% rise in 2 days) is based on a study with an 85% confidence interval in a cohort of only 20 female patients. More recent studies examining HCG dynamics in ART pregnancies are often confounded by multiple embryo transfer, replacement of unscreened embryos, and variation in the day of embryo development and normalization of endometrial transformation. The minimal HCG rise in early pregnancies conceived after single, euploid, frozen-thawed blastocyst transfer (FET) that correlates with good reproductive outcome has yet to be determined. The often quoted minimal serum HCG doubling time of early gestations (66% rise in 2 days) is based on a study with an 85% confidence interval in a cohort of only 20 female patients. More recent studies examining HCG dynamics in ART pregnancies are often confounded by multiple embryo transfer, replacement of unscreened embryos, and variation in the day of embryo development and normalization of endometrial transformation. The minimal HCG rise in early pregnancies conceived after single, euploid, frozen-thawed blastocyst transfer (FET) that correlates with good reproductive outcome has yet to be determined. DesignRetrospective cohort analysis. Retrospective cohort analysis. Materials and MethodsPatients that underwent single, euploid FET, from June 2011 to March 2016, were included. Oocyte donor cycles were excluded. Serum HCG levels were monitored on day 9 post FET, and if positive, on day 11. The rise was then correlated with implantation and ongoing pregnancy rates. Data was analyzed by student’s t-test, Chi-square, Kruskal-Wallis, linear and binary logistic regression. Patients that underwent single, euploid FET, from June 2011 to March 2016, were included. Oocyte donor cycles were excluded. Serum HCG levels were monitored on day 9 post FET, and if positive, on day 11. The rise was then correlated with implantation and ongoing pregnancy rates. Data was analyzed by student’s t-test, Chi-square, Kruskal-Wallis, linear and binary logistic regression. ResultsA total of 458 single, euploid FETs were included. HCG rise of ongoing pregnancies (mean: 158.74 ± 57 %; range: 9.5-698.32%) did not differ by maternal age (x2=1.55, p=0.82), BMI (x2=7.13, p=0.13) or blastocyst expansion grade (x2=0.69, p=0.71). The degree of HCG rise significantly correlated to successful implantation (OR 4.101 [95% CI 2.39-7.21], P<0.0001) and ongoing pregnancy (OR 3.51 [95% CI 1.83-6.74], P=0.0002), with a minimal threshold of 10.8% rise conferring a 50% probability of ongoing pregnancy (Table 1). This association was not influenced by maternal age (x2=5.09, p=0.28), BMI (x2=1.78, p=0.78) or blastocyst expansion stage (x2=0.03, p=0.98). A total of 458 single, euploid FETs were included. HCG rise of ongoing pregnancies (mean: 158.74 ± 57 %; range: 9.5-698.32%) did not differ by maternal age (x2=1.55, p=0.82), BMI (x2=7.13, p=0.13) or blastocyst expansion grade (x2=0.69, p=0.71). The degree of HCG rise significantly correlated to successful implantation (OR 4.101 [95% CI 2.39-7.21], P<0.0001) and ongoing pregnancy (OR 3.51 [95% CI 1.83-6.74], P=0.0002), with a minimal threshold of 10.8% rise conferring a 50% probability of ongoing pregnancy (Table 1). This association was not influenced by maternal age (x2=5.09, p=0.28), BMI (x2=1.78, p=0.78) or blastocyst expansion stage (x2=0.03, p=0.98). ConclusionsTabled 1Modeled probability of ongoing (clinical) pregnancy in relation to 48 hour serum HCG riseProbability of ongoing pregnancyPercent HCG rise over 48 hours50%10.8%75%106.5%80%131.4%90%202.2%95%272.9% Open table in a new tab" @default.
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• W2516644014 date "2016-09-01" @default.
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• W2516644014 title "Interpreting early HCG dynamics in the era of the thawed euploid single embryo transfer: how important is doubling?" @default.
• W2516644014 doi "https://doi.org/10.1016/j.fertnstert.2016.07.967" @default.
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