Obstetric and perinatal outcomes of pregnancies according to initial maternal serum HCG concentrations after vitrified–warmed single blastocyst transfer

Xiong, Feng; Li, Guan-Gui; Sun, Qing; Chen, Peilin; Wang, Zhuran; Wan, Caiyun; Yao, Zhihong; Zhong, Huixian; Zeng, Yong

doi:10.1016/j.rbmo.2018.12.040

Cited by 17 publications

(16 citation statements)

References 57 publications

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“…Another study shows that hCG and progesterone levels 14 days after oocyte retrieval may be predictive for continued pregnancy in patients with recurrent miscarriages (173). Another team showed similar results with the analysis of hCG 11 days after embryo transfer (28). hCG-H could also be used as a predictor for progressive pregnancy vs. nonprogressive pregnancy (174).…”

Section: Hcg and Miscarriagesmentioning

confidence: 82%

“…This rate remains higher than in nonpregnant women (26,27). It has been recently shown that during in vitro fertilization (IVF) treatments, faster-growing blastocysts produced significantly higher serum β-hCG concentrations 9 days after transfer than slower-growing blastocysts in fresh cycles, but the difference was not significant by day 16 after transfer (28).…”

Section: Hcg Secretionmentioning

confidence: 96%

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Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

et al. 2020

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Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hCG RNA is transcribed as early as the eight-cell stage, and the blastocyst produces the protein before its implantation. hCG in the uterine microenvironment binds with its cognate receptor, luteinizing hormone/choriogonadotropin receptor (LHCGR), on the endometrial surface. This binding stimulates leukemia inhibitory factor (LIF) production and inhibits interleukin-6 (IL-6) production by epithelial cells of the endometrium. These effects ensure essential help in the preparation of the endometrium for initial embryo implantation. hCG also effects angiogenic and immunomodulatory actions as reported in many articles by our laboratories and other ones. By stimulating angiogenesis and vasculogenesis, hCG provides the placenta with an adequate maternal blood supply and optimal embryo nutrition during the invasion of the uterine endometrium. The immunomodulatory properties of hCG are numerous and important for programming maternal immune tolerance toward the embryo. The reported effects of hCG on uterine NK, Treg, and B cells, three major cell populations for the maintenance of pregnancy, demonstrate the role of this embryonic signal as a crucial immune regulator in the course of pregnancy. Human embryo rejection for hCG-related immunological reasons has been studied in different ways, and a sufficient dose of hCG seems to be necessary to maintain maternal tolerance. Different teams have studied the addition of hCG in patients suffering from recurrent miscarriages or implantation failures. hCG could also have a beneficial or a negative impact on autoimmune diseases during pregnancy. In this review, we will discuss the immunological impacts of hCG during pregnancy and if this hormone might be used therapeutically.

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Section: Hcg and Miscarriagesmentioning

confidence: 82%

Section: Hcg Secretionmentioning

confidence: 96%

Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

et al. 2020

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“…Oron et al, demonstrated that for β-hCG that was measured 11 days after single blastocyst transfer, the optimal cut-off value for predicting clinical pregnancy was 137 IU/L with a PPV of 85% and an NPV of 75% [6]. The study by Xiong et al, determined that optimal thresholds were 152.2 IU/L and 211.9 IU/L respectively in predicting clinical pregnancy and live births in patients that had β-hCG tests 11 days after vitri ed-warmed blastocyst transfer [7]. Zhao et al, found that the single β-hCG value of 399.5 IU/L on day 12 after blastocyst transfer was reliable to predict clinical pregnancy with a PPV of 93.47% and an NPV of 67.61%.…”

Section: Discussionmentioning

confidence: 99%

“…In fresh embryo transfer cycles, the thresholds of serum β-hCG levels to predict clinical pregnancy and live births were 111-213 IU/L and 160-222.8 IU/L respectively 10-12 days after transfer [2][3][4][5][6][7]. For frozen embryo transfer, the cut-off value was 137-399 IU/L for clinical pregnancy and 212-411 IU/L for live births 11-12 days after embryo transfer [6][7][8]. Higher β-hCG levels are indicative of better pregnancy outcomes including higher rates of clinical pregnancy and live births [9].…”

Section: Introductionmentioning

confidence: 99%

Possibility of Live Birth in Patients with Low Serum β-hCG 14 Days After Blastocyst Transfer

Liu²

2020

Preprint

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Background: Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer.Methods: A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results: 312 patients had serum β-hCG levels <300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. Live birth rates were higher in the <38 years of age group as compared those > 38 years (19.0% vs.16.6%; P=0.045). ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%.Conclusions: Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG >58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

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“…3 Only the blastocysts with AA, AB, BA, BB, AC, CA, BC or CB scores were considered for transfer or cryopreservation. 17 A drop of blastocyst medium was collected in a 200-μ L centrifuge tube after the blastocyst was selected for fresh transfer. All the BCMs were stored at −80 C before antibody array detection.…”

Section: Human Embryo Culture and Bcm Collectionmentioning

confidence: 99%

Comparative secretome profile analysis of cultured immortalized human endometrial stromal cells supplemented with implanted versus nonimplanted blastocyst‐conditioned medium: A preliminary analysis

Xiong

Yao

Chen

et al. 2020

J of Obstet and Gynaecol

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Aim Human endometrial stromal cells (HESCs) were previously shown to be capable of discriminating embryos with different qualities. Here we aimed to compare the specific response of the HESC secretome to implanted blastocyst‐conditioned medium (BCM) versus nonimplanted medium and identify cytokine candidates useful for the assessment of blastocyst implantation. Methods Cleavage embryos were individually cultured in one microdrop of medium for blastocyst formation. The BCM was collected after fresh blastocyst transfer on day 5 and used to supplement HESC culture medium. A high‐throughput antibody array covering 440 cytokines was used to detect the secretory proteins of HESCs supplemented with implanted or nonimplanted BCM. Results A total of 22 differentially expressed proteins were found out of 440 cytokines in the supernatant of HESCs supplemented with BCM from the implanted group compared to the nonimplanted group, including seven upregulated and 15 downregulated proteins. Gene Ontology enrichment analysis showed that the differentially expressed proteins were mainly involved in cell chemotaxis and motility, and ERK1/2 cascade regulation. Kyoto Encyclopedia of Genes and Genomes analysis suggested that the mitogen‐activated protein kinase and phosphatidylinositol 3 kinase/Akt pathways were mainly involved. Conclusion HESCs specifically responded to BCM from different quality blastocysts, a finding that can be used to develop a novel approach for blastocyst quality assessment.

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Obstetric and perinatal outcomes of pregnancies according to initial maternal serum HCG concentrations after vitrified–warmed single blastocyst transfer

Cited by 17 publications

References 57 publications

Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

Possibility of Live Birth in Patients with Low Serum β-hCG 14 Days After Blastocyst Transfer

Comparative secretome profile analysis of cultured immortalized human endometrial stromal cells supplemented with implanted versus nonimplanted blastocyst‐conditioned medium: A preliminary analysis

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