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The aim of this study was to determine the prognostic value of single and paired measurements of serum concentrations of human chorionic gonadotrophin (HCG) for successful pregnancy following in-vitro fertilization (IVF) and tubal embryo transfer (TET). We analysed serum HCG concentrations 15 and 22 days after IVF or TET in 198 conception cycles. Cut-off values of serum HCG were determined by a receiver operating characteristic (ROC) curve. On the basis of single HCG samples on day 15 (HCG15) after transfer, using a cut-off value of HCG15 = 150 mIU/ml, the sensitivity was 71% and the specificity was 77%. The positive predictive value (HCG15 &gt; or = 150 mIU/ml indicating a normal pregnancy) was 89%, while the negative predictive rate (HCG15 &lt; 150 mIU/ml indicating an abnormal pregnancy) was 51%. Patients with HCG15 &lt; 150 mIU/ml but HCG22/HCG15 ratio &gt; or = 15, still had a 90% chance of normal pregnancy. However, in patients with HCG15 &lt; 150 mIU/ml and an HCG22/HCG15 ratio &lt; 15, there was an 84% chance of an abnormal pregnancy. We conclude that a single HCG15 determination combined with the ratio of HCG22 to HCG15 has a higher diagnostic accuracy for prediction of pregnancy outcome than either analysis alone.

Paired human chorionic gonadotrophin determinations for the prediction of pregnancy outcome in assisted reproduction