The role of early ß-hCG increase after ICSI in predicting pregnancy outcome in women under and over 35 years of age

Öz

Aim: β-human chorionic gonadotropin (β-hCG) is a biomarker that provides high sensitivity and reliability for predicting the pregnancy outcome at the earliest stage. Prior studies have reported that in addition to β-hCG measurement on a single day, the course of increase in β-hCG levels is important for predicting the gestational prognosis. We aimed to investigate the role of β-hCG increase in predicting pregnancy outcome following ICSI depending on maternal age. Materials and Methods: The data of 1977 patients whose ß-hCG values were measured on days 10 and 12 after embryo transfer were analyzed retrospectively. The patients were divided into two groups: younger than 35 years and 35 years old or older. Results: Measurements obtained on both days and the rate of increase of ß-hCG were found higher in patients under 35 years of age. Moreover, the rate of increase of ß-hCG was lower in biochemical pregnancies in both age groups. No significant difference was obtained in comparisons of the other groups including clinical pregnancy, abortion, ectopic pregnancy, ongoing pregnancy and live birth. Conclusion: The rate of increase in serum β-hCG levels decreased with increasing maternal age. The increase rate was significantly lower in biochemical pregnancy cases in both age groups, while no significant difference was found when the other pregnancy groups are compared. Most of the studies are limited by the small sample size. The rate of increase of β-hCG in the early period might be beneficial especially for timely initiation of necessary controls and sensitive management of biochemical pregnancies.

Anahtar Kelimeler

• ß-hCG
• pregnancy
• ICSI
• maternal age

ICSI sonrası erken dönem ß-hCG artış oranın 35 yaş altı ve üzeri kadınlarda gebelik prognozunu öngörmedeki rolü

Öz

Amaç: Gebeliği doğrulama ve sonucunu daha erken aşamada tahmin edebilmeye yönelik maternal serum belirteçleri arasında β-human koryonik gonadotropin (β-hCG) yüksek duyarlılık ve güvenirlilik sağlayan bir biyobelirteçtir. Yapılan çalışmalar, tek gündeki β-hCG ölçümüne ek olarak β-hCG değerinin artma seyrinin de gebelik sonucunu öngörmede yararlı olduğunu bildirmiştir. Çalışmamızda ICSI işlemlerini takiben erken dönem β-hCG artış oranının maternal yaşa bağlı olarak gebelik prognozunu öngörmedeki yerinin araştırılması amaçlanmıştır. Gereçler ve Yöntem: ICSI tedavisi sonrası gebelik oluşan ve ß-hCG değerleri embriyo transferinden 10 ve 12 gün sonra ölçülmüş 1977 hastanın verileri retrospektif olarak incelenmiştir. Hastalar 35 yaş altı ve üzeri olarak iki gruba ayrılmışlardır. Bulgular: Her iki gün elde edilen ölçümler ve ß-hCG artış oranı 35 yaş altı hastalarda daha yüksek bulunmuştur. Her iki yaş grubunda da kimyasal gebelik olgularında ß-hCG artış oranı daha düşük bulunmuştur. Gebelik kesesi görülmeyen vakalar haricinde klinik gebelik, abortus, ektopik gebelik, devam eden gebelik ve canlı doğum olgularının dahil olduğu diğer gebelik grupları arasındaki karşılaştırmalarda istatistiksel olarak anlamlı farklılık saptanmamıştır. Sonuç: Artan maternal yaş ile birlikte β-hCG artış oranı azalmıştır. Hem 35 yaş altı hem de üzerindeki hastalarda bu artış oranı kimyasal gebelik olgularında diğer gebelik gruplarına göre daha düşükken, diğer gruplarda bir fark olmadığı gösterilmiştir. Mevcut çalışmaların çoğu örneklem büyüklüğü ile sınırlıdır. Erken dönem β-hCG artış oranı belirlenmesinin özellikle kimyasal gebelik olgularının daha erken yönetimi ve hassas takibi için faydalı olacağı düşünülmektedir.

Anahtar Kelimeler

• ß-hCG
• gebelik
• ICSI
• maternal yaş

Kaynakça

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