Logarithmic Curves Depicting Initial Level and Rise of Serum Beta Human Chorionic Gonadotropin and Live Delivery Outcomes with in Vitro Fertilization: an Analysis of 6021 Pregnancies

Objective: To correlate the live delivery rate with the initial level and rise of serum beta-hCG.

Design: Retrospective cohort analysis.

Setting: Large private academic center for assisted reproductive technologies and infertility.

Patient(s): Records of all patients from 1999 to 2005 undergoing IVF with detectable early serum beta-hCG after ET.

Intervention(s): None.

Main Outcome Measure(s): Live delivery rate.

Result(s): Data from 6021 pregnancies were analyzed. Initial beta-hCG was predictive for delivery rate for all patients and for each age group. After controlling for the first beta-hCG, there were higher loss rates as age increased. Percent rise in second beta-hCG drawn 2 days later added predictive value. A decline in beta-hCG almost always resulted in a failure to deliver. There was a progressive increase in delivery rate as the percent rise in beta-hCG went from 0 to 100%; however, there was no further enhancement in delivery rates beyond the 100% rise point. While a better rise in beta-hCG was a good prognostic factor in all age groups, the differences in outcomes for the different age groups remained, even after controlling for first beta-hCG and percent rise.

Conclusion(s): Initial level and rise in beta-hCG predicts live delivery rate, with oocyte age providing additional predictive value. The established logarithmic curves should provide convenient reference tools for tracking outcomes and counseling patients.