DIAGNOSTIC VALUE OF EARLY SERUM CHORIONIC GONADOTROPIN CONCENTRATION FOR CLINICAL PREGNANCY AND LABOR PREDICTION AFTER ASSISTED REPRODUCTIVE TECHNOLOGIES

Abstract

The aim. To determine the diagnostic value of early chorionic gonadotropin (hCG) levels in predicting clinical pregnancy and labor after assisted reproductive technologies. Methods. A retrospective study was performed at the Hospital of Lithuanian University of Health Sciences (LSMU) Kauno klinikos, Reproductive Medicine Centre. The analysis included cases in the period 2022, when women 9–10 days after the transfer of one fresh (ET (BL)) or frozen (FET) blastocyst into the uterus, had a chorionic gonadotropin (hCG) test result of > 10 U/l at the Department of Laboratory Medicine, Hospital of LSMU, Kauno klinikos and clear pregnancy outcome. The accuracy of hCG in predicting clinical pregnancy and delivery after assisted reproduction and the test’s diagnostic value were evaluated. Statistical data analysis was performed using IBM SPSS Statistics 29. Results. The median hCG concentration in the ET (BL) group is 130.45 U/l, and in the FET group – 152.2 U/l (p = 0.192). The median hCG concentration was statistically significantly higher in the case of delivery compared to biochemical pregnancy in the ET (BL) group (p = 0.005) and compared to biochemical pregnancy or early termination of pregnancy in the FET group (p < 0.001). The optimal threshold hCG concentration for clinical pregnancy prediction, without considering the type of blastocyst, is 79.65 U/l. This concentration is 66.15 U/l in the ET (BL) group and 114.15 U/l in the FET group. The optimal threshold hCG concentration for the labor prediction is 137.75 U/l when the blastocyst type is not considered. For ET (BL) and FET, this concentration is 66.15 U/l and 138.35 U/l respectively. Conclusions. The early hCG concentration test is a good test to predict clinical pregnancy and labor, and a fair test to exclude these possibilities. Early hCG concentration after the transfer of a frozen-thawed blastocyst into the uterus is a fair test for predicting labor and for excluding this possibility. The small sample size and uneven distribution of cases make the test’s clinical value questionable in the case of a fresh blastocyst.