Predictive value of serum progesterone level on ß-hCG check day in women with previous repeated miscarriages after in vitro fertilization

Yong Jin Kim, Jung Ho Shin, Jun Yong Hur, Hoon Kim, Seung Yup Ku, Chang Suk Suh

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective To evaluate the predictive value of the progesterone level at the beta-human chorionic gonadotropin (ß-hCG) check day for ongoing pregnancy maintenance in in vitro fertilization (IVF) cycles in women with previous unexplained repeated miscarriages. Materials and methods One hundred and forty-eight women, with visible gestational sac after IVF, were recruited in this observational study. All subjects had unexplained recurrent miscarriages in more than two previous IVF cycles. The progesterone level at the ß-hCG check day (i.e. 14 days after oocyte retrieval) was assessed. The area under the curve (AUC) of the progesterone level was evaluated to predict the ongoing pregnancy or miscarriage outcomes. Results The overall ongoing pregnancy rate was 60.8% (90/148). The cut-off value with ß-hCG levels higher than 126.5 mIU/mL and with progesterone levels higher than 25.2 ng/mL could be the predictive factors for ongoing pregnancy maintenance (AUC = 0.788 and 0.826; sensitivity = 0.788 and 0.723; specificity = 0.689 and 0.833; P < 0.0001 and P < 0.0001, respectively). The miscarriage rates were 19.5% (15/77) in the women with ß-hCG > 126.5 mIU/ mL and 13.0% (10/77) in those with > 25.2 ng/mL. In the comparison of the ROC curves between both values, a similar significance was found. The subjects with ß-hCG > 126.5 mIU/mL and progesterone > 25.2 ng/mL showed higher ongoing pregnancy rates [98.0% (49/50) vs. 41.8% (41/98)] than those with ß-hCG 126.5 mIU/mL or progesterone 25.2 ng/mL. Conclusions The progesterone level at 14 days after oocyte retrieval can be a good predictive marker for ongoing pregnancy maintenance in women with repeated IVF failure with miscarriage, together with the ß-hCG level. The combined cut-off value of progesterone > 25.2 ng/mL and ß-hCG > 126.5 mIU/mL may suggest a good prognosis.

Original languageEnglish
Article numbere0181229
JournalPLoS ONE
Volume12
Issue number7
DOIs
StatePublished - Jul 2017

Bibliographical note

Publisher Copyright:
© 2017 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cite this