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

ObjectiveTo correlate the live delivery rate with the initial level and rise of serum β-hCG.DesignRetrospective cohort analysis.SettingLarge 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 β-hCG after ET.Intervention(s)None.Main Outcome Measure(s)Live delivery rate.Result(s)Data from 6021 pregnancies were analyzed. Initial β-hCG was predictive for delivery rate for all patients and for each age group. After controlling for the first β-hCG, there were higher loss rates as age increased. Percent rise in second β-hCG drawn 2 days later added predictive value. A decline in β-hCG almost always resulted in a failure to deliver. There was a progressive increase in delivery rate as the percent rise in β-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 β-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 β-hCG and percent rise.Conclusion(s)Initial level and rise in β-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.