Authors:
Lan Le Thi Phuong MD, OB/GYN.
Yen Diem Thi MD, Lien Tran Kim BSN.
The ART Center, Vinmec Times City International Hospital, Hanoi, Vietnam.
INTRODUCTION
Though pregnancy rates after an IVF/ ICSI cycle can be 50 – 60%, the birth rate is only ~ 20 – 22%. It is comparable with natural pregnancy (Schieve &CS, 2003). In which, 30% pregnancies fail very early, at the pre-implantation stage, 30% at implantation (or biochemical pregnancies). Biochemical or preclinical pregnancies that are only identifiable by raised serial bhCG measurements and clinical pregnancies for which ultrasound or histological evidence of gestation can be found. The reasons leading to early pregnancy failure is not clear, it might be divided into two groups: a) The patient dependent factors such as chromosomal abnormalities and maternal age, thrombophilia, high NK cells; b) IVF/ICSI cycle-dependent factors: Luteal phase support and embryonic factors. There are serial predictors for successful pregnancy from ART treatment. History of early pregnancy failure, endometrial thickness <7mm are negative factors, ultrasound monitoring during early pregnancy also help predict subsequent failure. With regards to bhCG, estradiol (E2) monitoring after IVF/ICSI cycles, the study of Alexis P et.al, 2015 in 5471 cycles suggested that a level of bhCG on day 14 days post-embryo transfer <50, 100iu/ml is associated significant with clinical pregnancy and live birth rate of 27% and 15%; 60.5% and 41.2%; 91.9% and 77.4%. Combination serum level of bhCG and E2, the patients has bhCG < 50iu/ml and E2 10ng/ml. The study used serum level of bhCG, E2 and progesterone on day 14 post- embryo transfer as predictors for frozen embryo transfer cycles.
THE AIM OF THE STUDY
To evaluate the value of bhCG, E2 and progesterone level on day 14 after embryo transfer as a predictor for pregnancy success after frozen embryo transfers. Whether progesterone addition can improve the outcome.
METHODS
Retrospective research was conducted on 316 patients who were transferred frozen-embryos from 1-8/2017 in ART center, Vinmec Times City, under 40 years old and had a normal uterus. The serum E2 (ng/ml), P4 (ng/ml), βHCG (mIU/ml) level was determined on the 14th day after frozen embryo transfer. The patient is diagnosed with pregnancy when bhCG >25iu/ml. Endometrium was classified by transvaginal ultrasonography base on thickness, morphology, vascular penetration and blood flow velocimetry. The results assess the rate of biochemical pregnancy, clinical pregnancy, ongoing pregnancy, multiple-pregnancy, abortion.
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