Weekly changes in serum β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in women with unexplained recurrent miscarriage

Objective To investigate the efficacy of weekly measurement of beta-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in patients with unexplained recurrent miscarriage.Methods We retrospectively included patients with unexplained recurrent miscarriage whose serum beta-human chorionic gonadotropin, estradiol, and progesterone levels were measured three or more times during early pregnancy. The patients were divided into two groups according to pregnancy outcomes. The Delta beta-human chorionic gonadotropin, Delta estradiol, and Delta progesterone levels of the two groups were compared, and the corresponding cutoff values were determined using receiver operating characteristic analyses for predicting pregnancy outcome.Results A total of 140 patients were analyzed. From the 6th week to 10th week, the serum beta-human chorionic gonadotropin and estradiol levels of the ongoing pregnancy group were significantly higher than those of the miscarriage group. The serum Delta beta-human chorionic gonadotropin levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.841 (95% confidence interval: 0.769-0.914) and diagnostic cutoff value of 30,633 mIU/mL. The Delta estradiol levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.839 (95% confidence interval: 0.752-0.926) and a cutoff value of 45 pg/mL.Conclusions Weekly remeasurement of serum beta-human chorionic gonadotropin and estradiol may be useful for pregnancy risk assessment in patients with unexplained recurrent miscarriage in clinical practice.