Weekly changes in serum β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in women with unexplained recurrent miscarriage.

Abstract

ObjectiveTo investigate the efficacy of weekly measurement of β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in patients with unexplained recurrent miscarriage.MethodsWe retrospectively included patients with unexplained recurrent miscarriage whose serum β-human chorionic gonadotropin, estradiol, and progesterone levels were measured three or more times during early pregnancy. The patients were divided into two groups according to pregnancy outcomes. The Δβ-human chorionic gonadotropin, Δestradiol, and Δprogesterone levels of the two groups were compared, and the corresponding cutoff values were determined using receiver operating characteristic analyses for predicting pregnancy outcome.ResultsA total of 140 patients were analyzed. From the 6th week to 10th week, the serum β-human chorionic gonadotropin and estradiol levels of the ongoing pregnancy group were significantly higher than those of the miscarriage group. The serum Δβ-human chorionic gonadotropin levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.841 (95% confidence interval: 0.769-0.914) and diagnostic cutoff value of 30,633 mIU/mL. The Δestradiol levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.839 (95% confidence interval: 0.752-0.926) and a cutoff value of 45 pg/mL.ConclusionsWeekly remeasurement of serum β-human chorionic gonadotropin and estradiol may be useful for pregnancy risk assessment in patients with unexplained recurrent miscarriage in clinical practice.