Serum Human Chorionic Gonadotropin Level Measured 17 Days After Oocyte Retrieval Can Predict Final Clinical Pregnancy Outcomes in IVF/ICSI Treatment Cycles

OBJECTIVE: To investigate whether serum human chorionic gonadotropin (hCG) levels measured 17 days after oocyte retrieval can predict final clinical pregnancy outcomes in in vitro fertilization/intracytoplasmic sperm injection embryo transfer cycles. STUDY DESIGN: Serum hCG levels 17 days after oocyte retrieval and the subsequent clinical pregnancy outcomes in patients with positive serum hCG were analyzed. RESULTS: Of 6,560 patients, patients with positive but low serum hCG levels (<100 IU/L) had an increased risk of abnormal clinical pregnancy outcomes (spontaneous miscarriage or ectopic pregnancy) (p < 0.05). Compared with abnormal clinical pregnancy, normal clinical pregnancy (live birth) showed significantly higher hCG levels at 17 days after oocyte retrieval (596.80 IU/L vs. 277.80 IU/L, p < 0.001). The hCG level of live birth was markedly higher than that of spontaneous miscarriage (596.80 IU/L vs. 357.15 IU/L, p < 0.001) and ectopic pregnancy (596.80 IU/L vs. 129.30 IU/L, p < 0.001). The cutoff value was 377.8 IU/L to predict live birth with 0.730 area under the receiver operating characteristic curve (95% CI 0.713-0.747, 75.9% sensitivity, 61.2% specificity, p < 0.001). CONCLUSION: Serum hCG levels measured on the 17th day after oocyte retrieval are clinically useful in predicting final clinical pregnancy outcomes. However, it is important to note that no hCG cutoff had a sensitivity or specificity of 100% for either normal or abnormal pregnancies, making it essential to continue routine monitoring of assisted reproductive technology pregnancy outcomes.