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

Abstract

Objective To investigate the efficacy of weekly measurement of β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in patients with unexplained recurrent miscarriage. Methods We 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. Results A 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. Conclusions Weekly 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.