Embriyo Transferi Sonrası 12. ve 14. Günlerde Ölçülen Beta hCG Değerinin Gebelikte Erken Komplikasyonların Belirlenmesindeki Rolü

Abstract

Amaç: Bu çalışmanın amacı, embriyo transferi (ET) sonrası 12. ve 14. gündeki beta human chorionic gonadotropin (beta hCG) düzeylerinin ve 48 saat sonraki katlanmasının canlı doğum, düşük ve biyokimyasal gebeliği öngörmedeki rolünün araştırılmasıdır. Gereç ve Yöntemler: Çalışmaya 2017 ve 2021 yılları arasında tüp bebek (in vitro fertilization, IVF) merkezinde taze tek 3. gün ET sonrası gebelik testi pozitif çıkan 124 hasta dahil edildi. İlk beta hCG değeri ET'den sonra 12. gün, ikincisi ise 14. gün ölçüldü. Beta hCG katlanması, ikinci beta hCG değerinin birinci beta hCG değerine bölünmesiyle hesaplandı. Bulgular: Hastaların IVF endikasyonları arasında açıklanamayan (n=40, %41,1), kötü over rezervi (n=23, %25,0), erkek faktörü (n=31, %29,8) ve tubal faktör (n=3, %4,1) yer alıyordu. 124 hastanın 97'sinde (%78,2) gebelik kesesi, 81'inde (%63,5) fetal kalp atışı (fetal heartbeat, FHB) ve 70'inde (%56,5) canlı doğum gerçekleşti. Sonuçlar, ET sonrası 14. gün beta hCG düzeyinin biyokimyasal gebeliğin en iyi belirleyicisi olduğunu gösterdi. 175 U/L optimum kesim değeri ile yüksek bir duyarlılığa (%92,5) ve özgüllüğe (%86,6) sahipti. ET sonrası 14. gün beta hCG düzeyi canlı doğumun da en iyi belirleyicisiydi. ET sonrası 14. gün 214,5 U/L beta hCG değerinin FHB'yi öngörmedeki duyarlılığı %82,7, özgüllüğü ise %74,4 idi. Sonuç: ET sonrası 12. ve 14. günler arasında ölçülen beta hCG değeri ve bu iki gündeki katlanma oranı gebeliğin seyri hakkında bilgi verebilir.

Keywords

• Beta hCG
• canlı doğum oranı
• embriyo transferi sonrası
• gebelik sonucu

The Role of Beta hCG Value Measured on the 12th and 14th Days After Embryo Transfer in Determining Early Complications of Pregnancy

Abstract

Aim: This study aimed to investigate the role of beta human chorionic gonadotropin (beta hCG) levels on post embryo transfer (ET) 12th- and 14th-day, and its folding after 48 hours in predicting live birth, abortion, and biochemical pregnancy. Material and Methods: The study included 124 patients who had a positive pregnancy test after a fresh single day 3 ET at the in vitro fertilization (IVF) center between 2017 and 2021. The first beta hCG value was measured 12th day and the second 14th day after ET. The beta hCG fold was calculated by dividing the second beta hCG value by the first beta hCG value. Results: The patients' IVF indications included unexplained (n=40, 41.1%), poor ovarian reserve (n=23, 25.0%), male factor (n=31, 29.8%), and tubal factor (n=3, 4.1%). Of the 124 patients, 97 (78.2%) had a fetal sac, 81 (63.5%) had a fetal heartbeat (FHB), and 70 (56.5%) had a live birth. The results indicated that the post-ET 14th-day beta hCG level was the best predictor of biochemical pregnancy. It has a high sensitivity (92.5%) and specificity (86.6%), with an optimal cut-off value of 175 U/L. The post-ET 14th-day beta hCG level was the best predictor of a live birth. The post-ET 14th-day beta hCG value of 214.5 U/L had an 82.7% sensitivity and 74.4% specificity to predict the FHB. Conclusion: The beta hCG value, measured between the 12th and 14th days after ET, as well as the folding rate on these two days, can provide information about the pregnancy progression.

Keywords

• Beta hCG
• live birth rate
• post embryo transfer
• pregnancy outcome

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