October 21st, 2018

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Title:
Successful Live Birth Following Low hCG Level (6.1 mIU/mL at 4 Weeks’ Gestation) After in Vitro Fertilization and Embryo Transfer: A Case Report
Authors:  Chuyu Hayashi, M.D., Ph.D., Kaori Matsumoto, Akikazu Nakamura, M.D., Ph.D., and Fumihisa Chishima, M.D., Ph.D.
 
BACKGROUND: Human chorionic gonadotropin (hCG) is used as an endocrine marker of pregnancy. hCG values >10 mIU/mL are usually reached 3–7 days after implantation. Here, we describe a successful live birth in a patient whose hCG level was 6.1 mIU/mL at 14 days after oocyte retrieval.

CASE: The patient was a 32-year-old Japanese woman, gravida 0. At 26 years of age she underwent a right adnexectomy and was diagnosed with an ovarian tumor of borderline malignancy. Five years after surgery she began ovulation induction treatment with clomiphene citrate but did not achieve pregnancy. Thus, we performed in vitro fertilization. At 3 days after oocyte retrieval 1 embryo reached the 7-cell stage, and a fresh embryo transfer was performed on the patient. Although her serum level of hCG was 6.1 mIU/mL 14 days after oocyte retrieval, pregnancy was continued. She delivered a healthy female infant at 40 weeks’ gestation. We concluded that the low concentration of hCG appeared to be a result of delayed implantation according to the logarithmic growth curve model of serum hCG levels.

CONCLUSION: When hCG concentrations are low in early IVF-ET pregnancy, pregnancy progression must be observed carefully.
Keywords:  delayed embryo implantation; embryo transfer; HCG; HCG-beta; human chorionic gonadotropin, beta subunit; in vitro fertilization; IVF-ET; live birth oocyte retrieval
   
   
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