The aim of this study was to determine the prognostic value of single and paired measurements of serum concentrations of human chorionic gonadotrophin (HCG) for successful pregnancy following in-vitro fertilization (IVF) and tubal embryo transfer (TET). We analysed serum HCG concentrations 15 and 22 days after IVF or TET in 198 conception cycles. Cut-off values of serum HCG were determined by a receiver operating characteristic (ROC) curve. On the basis of single HCG samples on day 15 (HCG 15 ) after transfer, using a cut-off value of HCG 15 = 150 mIU/ml, the sensitivity was 71% and the specificity was 77%. The positive predictive value (HCG 15 ≤ 150 mIU/ml indicating a normal pregnancy) was 89%, while the negative predictive rate (HCG 15 < 150 mIU/ml indicating an abnormal pregnancy) was 51%. Patients with HCG 15 < 150 mIU/ml but HCG 22 /HCG 15 ratio ≤ 15, still had a 90% chance of normal pregnancy. However, in patients with HCG 15 < 150 mIU/ml and an HCG 22 /HCG 15 ratio < 15, there was an 84% chance of an abnormal pregnancy. We conclude that a single HCG 15 determination combined with the ratio of HCG 22 to HCG 15 has a higher diagnostic accuracy for prediction of pregnancy outcome than either analysis alone.
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