3 years ago

Maternal β-hCG levels in early IVF pregnancy: association with the embryo development stage of blastocyst

Wenyue Zhu, Queenie Yeung, David Chan, Ling Chi, Jin Huang, Qiong Wang, Jacqueline Chung, Tc Li

Publication date: Available online 8 January 2019

Source: Reproductive BioMedicine Online

Author(s): Wenyue Zhu, Queenie Yeung, David Chan, Ling Chi, Jin Huang, Qiong Wang, Jacqueline Chung, TC Li

Research Question

Does the development stage of the blastocyst on embryo transfer (ET) day affect the serum β-human chorionic gonadotropin (β-hCG) level 9 days and 16 days after embryo transfer in women whose pregnancy progressed to beyond 13 weeks?


The retrospective study involved 204 cases whose pregnancy progressed to beyond 13 weeks of single blastocyst transfer in fresh (n=66) or frozen (n=138) cycles in a teaching hospital IVF clinic from January 2015 to September 2016.


The β-hCG levels on both 9 days and 16 days after ET in frozen cycles (median, 223 IU/L and 4378 IU/L respectively) were significantly (P<0.001) higher than those in fresh cycles (157 IU/L and 2813 IU/L).Among fresh cycles, faster growing blastocysts (expanded + hatching+ hatched blastocysts) produced significantly (p<0.001) higher β-hCG levels 9 days after ET (191 IU/L), than slower growing blastocyst (cavitating + full blastocyst, 106 IU/L) but there was no longer any significant difference (p=0.188) between the faster growing and slower growing groups by day 16 after ET (2359 IU/L & 3025 IU/L respectively). Among frozen cycles, there was no difference in the β-hCG level between blastocysts of different development stage 9 and 16 days after transfer.


Faster growing blastocysts produced significantly higher serum β-hCG levels 9 days after transfer than slower growing blastocysts in fresh cycles, but the difference was no longer significant by day 16 after transfer. In addition, β-hCG levels 9 and 16 days after embryo transfer in frozen-thawed ET cycles were higher than that of fresh ET cycles. The interpretation of β-hCG results 9 days after blastocyst transfer should take into consideration the growth rate of the blastocyst and whether fresh or frozen embryo was transferred.

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