Predictive value of plasma human chorionic gonadotrophin following assisted conception treatment

A total of 429 pregnancies after assisted conception treatment was analysed , using receiver operator characteristic curves. The best balance between s ensitivity and specificity for predicting viable (single and multiple birth s) and non-viable (fetal heart positive abortions, ectopic and biochemical pregnancies) outcomes was human chorionic gonadotrophin (HCG) 50 IU/l on da y 14 and 200 IU/l on day 21 after treatment. Utilizing these indices all pr egnancies could be classified into one of four groups. In group A (day 14 H CG <50 IU/l and day 21 <200 IU/l), the probability of a birth was 0%, pregn ancy loss 72% and ectopic pregnancy 28%. Conversely for group D (day 14 HCG >50 nm and day 21 >1000 IU/l), the likelihood of a birth was 90%, pregnanc y loss 8% and ectopic pregnancy only 1%. Between groups A and D there was, as expected, a gradually shifting balance in favour of a reduction in ectop ic (28, 13, 3, 1%) and biochemical pregnancies (70, 36, 33, 2%) and an incr ease in fetal heart positive pregnancy losses (2, 6, 13, 7%) and births (0, 44, 50, 90%). The majority of multiple pregnancies (98%) occurred in group D. Two accurately linked HCG measurements allowed a greater predictive acc uracy of pregnancy outcome than could be obtained using either alone.