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

Jaimin S Shah; Anna M Modest; Michele R Hacker; Nina Resetkova; Laura E Dodge

doi:10.7759/cureus.28117

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

Cureus. 2022 Aug 17;14(8):e28117. doi: 10.7759/cureus.28117. eCollection 2022 Aug.

Authors

Jaimin S Shah^{1

2}, Anna M Modest^{1

3}, Michele R Hacker^{1

3

4}, Nina Resetkova², Laura E Dodge^{1

3

4}

Affiliations

¹ Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
² Reproductive Endocrinology and Infertility, Boston In Vitro Fertilization (IVF), Waltham, USA.
³ Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, USA.
⁴ Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.

Abstract

Objectives: To evaluate whether an initial or two-day percent increase in serum beta-human chorionic gonadotropin (βhCG) 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 βhCG nor two-day percent increases in βhCG were associated with an increased risk of IPD for any type of IVF cycle. Initial and two-day percent increases in βhCG 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 βhCG were not associated with IPD or its components. However, significant βhCG differences existed by cycle type and oocyte source.

Keywords: beta human chorionic gonadotropin; in vitro fertilization; ischemic placental disease; placental abruption; preeclampsia; small for gestational age.