Association of Early Beta Human Chorionic Gonadotropin With Ischemic Placental Disease in Singleton Pregnancies After In Vitro Fertilization

Objectives: To evaluate whether an initial or two-day percent increase in serum beta-human chorionic gonadotropin (I3hCG) is associated with ischemic placental disease (IPD) in singleton pregnancies after autologous or donor IVF. Study design: This was a secondary analysis of a retrospective cohort study of deliveries linked to IVF cycles at a single academic tertiary hospital and infertility treatment center. We included all patients (>= 18 years old) who had a singleton live birth or intrauterine fetal demise (IUFD) resulting from either autologous fresh (n=1,347), autologous frozen (n=454), or donor (n=253) IVF cycles. Main outcome reassures: The primary outcome was a composite outcome of IPD or IUFD due to placental insufficiency. IPDs included preeclampsia, placental abruption, and small for gestational age (SGA). Results: Neither initial I3hCG nor two-day percent increases in I3hCG were associated with an increased risk of IPD for any type of IVF cycle. Initial and two-day percent increases in I3hCG were significantly higher when comparing frozen with fresh IVF and donor with autologous IVF (all P <= 0.01). Conclusions: Among singleton autologous and donor IVF cycles, the initial and two-day percent increase in serum I3hCG were not associated with IPD or its components. However, significant I3hCG differences existed by cycle type and oocyte source.