PREDICTIVE VALUE OF HCG LEVEL 14 DAYS AFTER EMBRYO-TRANSFER

Objective: It has been reported that the quantitative serum hCG level 14 days after embryo transfer (ET) correlated with pregnancy outcome a s well as a likelihood of a multiple gestation pregnancy. This prospec tive study was designed to assess the predictive value of a 14-day pos t-ET hCG level with pregnancy outcome and multiple gestation pregnanci es. Methods: Patients undergoing in vitro fertilization (NF) and ET we re monitored by serum quantitative hCG levels 14 days after ET. If pos itive, serial values of hCG were obtained and transvaginal ultrasound was performed 3 weeks after ET and weekly until fetal cardiac activity was seen. Ongoing pregnancies were defined as greater than 20 weeks. Results: One hundred eleven patients had positive serum quantitative h CG levels 14 days post-ET; 89/111, or 80.2%, had ongoing pregnancies. The spontaneous miscarriage rate was, therefore, 19.8% (22/111). If th e level was less than 300, the ongoing multiple pregnancy rate was 9% (5/57). If the level was between 300 and 600, the ongoing pregnancy ra te was 40% (10/25). If the hCG level was greater than 600, the multipl e pregnancy rate was 100% (7/7). Conclusions: These data support the h ypothesis that hCG levels greater than 200 mIU/ml on 14 days post-ET a re more likely to have ongoing pregnancies; hCG levels greater than 60 0 have a high likelihood of a multiple gestation pregnancy.