Previsão de gravidez pós‐fertilização in vitro de acordo com valor de β‐hCG e progesterona

Abstract

Introduction

Multiple studies suggest that the amount of β‐hCG and progesterone can be good predictors of pregnancy.

Objective

To investigate the potential of β‐hCG and progesterone values in predicting evolutive pregnancy and twin pregnancy, 14 days after oocyte puncture in IVF/ICSI cycles, establishing a predictive model.

Methods

A retrospective study of cycles with the use of a puncture and fresh embryo transfer between May/2011 and September/2015. The defined groups were: with no pregnancy; without evolutive pregnancy; and with evolutive (single or twin) pregnancy. Statistical analysis considered α = 5%. To assess the ability to predict evolutive pregnancy and twin pregnancy, a multivariate analysis model was carried out, with the use of a binary logistic regression process. ROC curves were used to evaluate the ability of β‐hCG and progesterone values in differentiating between non‐evolutive and evolutive pregnancy.

Results

149 cases were found: no pregnancy 11.4%, without evolutive pregnancy 24.8%, with evolutive pregnancy 63.8% (83 single, 12 twins). Excluding progesterone and β‐hCG values, there were no statistically significant differences between the variables of non‐evolutive and evolutive pregnancy groups (β‐HCG: 38.9 vs. 159 IU/L, progesterone: 20.4 vs. 60 ng/mL). In a comparison between single and twin pregnancies, only the amount of β‐hCG was statistically significant (β‐HCG: 147 vs. 331 IU/L). When progesterone value is >25, the probability of pregnancy is 5.4 times greater (95% CI, 1.18‐24.8). In a logistic regression for twin pregnancies, only β‐hCG value was statistically significant.

Conclusion

A single assessment of progesterone and β‐hCG values 14 days after the puncture has a good predictive value of evolutive pregnancy, but with limited ability to discriminate between single and twin pregnancies.