Risk factors and HCG trends in patients with ruptured tubal ectopic pregnancies despite methotrexate treatment

Abstract

day of embryo transfer were used to estimate the linear regression beta and 95% confidence interval (CI) of mean initial hCG values and 2-day percent hCG rises.RESULTS: Mean initial serum hCG values were inversely correlated with BMI class (Table) (P-value test for linear trend <0.001). Obese women were more likely to have low initial serum hCG values (<100 mIU/mL) and this increased across BMI classes, ranging from 1.4% of normal weight patients to 25% of patients with BMI >40 kg/m 2 (p-value test for linear trend¼0.002). However, mean 2-day percent hCG rises were similar between normal weight and obese patients, and were normal (>53%) in all groups.CONCLUSIONS: When compared with normal weight patients, obese patients had significantly lower initial serum hCG values, but still achieved singleton live births. Mean 2-day percent rises in hCG were normal across all BMI classes. Rate of hCG rise remains the mainstay of monitoring early pregnancies following IVF, particularly as initial hCG values may lack sensitivity for live birth in obese patients. Elevated BMI is associated with increased blood volume, which may affect serum hCG concentration. Given the impact of BMI on this crucial blood test, future studies should explore whether BMI impacts the interpretation of other serum analytes.P-717 Wednesday, OBJECTIVE: To compare the ectopic pregnancy (EP) risk between blastocyst transfer cycles and cleaved embryo transfer cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in women with previous EP.DESIGN: Retrospective cohort study. MATERIALS AND METHODS: A total of 1,188 women who had previous EP and underwent frozen-thawed embryo transfer (FET) cycles of IVF/ICSI in the period between November 2007 and January 2015 were enrolled. After excluding those with uterine abnormities, uterine disorders, incomplete cycle information and other conditions that were not suitable for analysis, finally 1,148 pregnancies from 1,097 women were further analyzed. In the univariate analysis, the EP rate was compared by patient and treatment characteristics including maternal age, presence of prior full-term birth, Fallopian tubal diseases, previous Fallopian tubal surgery, polycystic ovary syndrome, endometriosis and male factor infertility, type of endometrial preparation, number and stage of embryos transferred, endometrial thickness on embryo transfer day and year of treatment. In order to account for the correlation between all pregnancies reported by the same woman, we used goodness of fit to specify the best fitted generalized estimated equation regression models to calculate unadjusted and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between EP and significant characteristics selected from the univariate analysis (P<0.20) plus year of treatment. Statistical analyses were carried out by SPSS version 23.0. In the univariate analysis, Chi-square test or Fisher's exact test was applied to perform rate comparisons as appropriate. In the multivariate analysis, P<0.05 ...