Predicting in vitro fertilization success: the role of hyperglycosylated human chorionic gonadotropin to beta-human chorionic gonadotropin ratio in implantation and early pregnancy outcomes at a private in vitro fertilization center in Baghdad

Abstract

Background

This study explores the role of human chorionic gonadotropin (hCG) isoforms in predicting implantation success and early pregnancy outcomes in in vitro fertilization (IVF) patients. Despite advances in reproductive medicine, implantation failure, and early pregnancy loss remain significant challenges. Hyperglycosylated hCG (hCG-H) facilitates trophoblast invasion and angiogenesis, while beta-hCG (β-hCG) supports progesterone production, crucial for pregnancy maintenance. This study assesses the predictive value of these biomarkers in IVF success.

Methods

A prospective cohort study was conducted at Al-Binuk Private IVF Center in Baghdad from January to December 2024, including 100 women aged 20 to 44 years with primary or secondary infertility and normal uterine cavities. Women with endocrine disorders or uterine abnormalities were excluded. All transferred embryos were frozen day 4 or day 5 embryos and were implanted into a prepared uterus. Serum hCG levels, including hCG-H and β-hCG, were measured 10 to 11 days after embryo transfer. Data were analyzed using SPSS, and logistic regression was performed to evaluate the predictive value of these biomarkers.

Results

The mean age of participants was 34.3 years, with 54% having a normal BMI. Primary infertility was more common (73%), with an average infertility duration of 5.9 years. Half of the participants underwent their first IVF attempt. Among pregnancies, 73% resulted in a single embryo, 13% in twins, and 14% experienced pregnancy failure. Higher hCG-H and β-hCG levels were significantly associated with implantation success, and an increased hCG-H to β-hCG ratio further enhanced prediction. Logistic regression showed that higher hCG levels improved implantation success, while age negatively affected outcomes.

Conclusion

Serum hCG-H and β-hCG levels measured postembryo transfer serve as strong predictors of IVF success. Their ratio further enhances predictive accuracy, emphasizing their role in assessing pregnancy viability. Further research is needed to refine diagnostic thresholds and enhance fertility treatment strategies.