The level of serum b-human chorionic gonadotropin hormone predicting clinical and continued pregnancy in IVF/ICSI cycles, in SPHMMC IVF center, Addis Ababa, Ethiopia, 2023

Abstract

Abstract Background: After assisted reproductive technology (ART), most IVF centers in the world measure serum beta human chorionic gonadotropin level not only to diagnose pregnancy but also to predict pregnancy outcomes. However, the results were inconsistent from setup to setup in most IVF centers, due to the serum beta human chorionic gonadotropin (Hcg) hormone was determined at different dates ranging from day eight to sixteen and most studies recommend each IVF hospital laboratory is supposed to have its own beta hcg cut-off value to predict pregnancy outcomes. This study will help in counseling and avoid adverse psycho-social impacts on the couple life and unnecessary stress on the managing physician. It will also be baseline information for further studies. Objective: The aim of this study was to determine the level of serum beta human chorionic gonadotropin hormone that can predict clinical and continued pregnancy in IVF/ICSI cycles in a recently opened public IVF center, Addis Ababa, Ethiopia, 2023. Methods: Using secondary data from the SPHMMC's Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility Unit database, a cross-sectional study design was used. Kobo toolbox was used to collect data from the electronic medical record of the center. After data completeness was checked, it was cleaned, coded and entered into computer software of STATA version 17 for analysis. Descriptive analysis was done for general characteristics of study participants. A receiver operating characteristic (ROC) curve was used to calculate the optimum β-hCG cutoff values to predict clinical pregnancy and continued pregnancy. The area under the curves and their 95% confidence intervals was calculated for each ROC curve. Results: This study included 331 IVF/ICSI cycles with serum hCG hormone level of >5miu/ml. The cutoff value for beta human chorionic gonadotropin hormone to predict clinical pregnancy is 226 miu/ml, with an AUC of 0.92, sensitivity of 90.24%, and specificity of 86.36%. The beta human chorionic gonadotropin hormone cutoff values to predict continued pregnancy was found to be at 448 miu/ml with AUC of 0.74, sensitivity of 77.97%, and specificity of 60.78% on ROC analysis Conclusion: The cutoff value of serum human chorionic gonadotropin hormone predicting clinical and continued pregnancy is relatively higher than the other studies.