A live birth with unexpectedly low serum human chorionic gonadotropin level on day 11 after blastocyst embryo transfer: a case report

Case Reports

Volume 1, Issue 1, Pages 48–50


Qizhen Zheng, M.D., Shiru Xu, M.D., Meilan Mo, M.D., Jing You, B.D., Yong Zeng, M.D.



To report a very rare case of live birth with unexpectedly low serum hCG level on day 11 after blastocyst embryo transfer.


Case report.


Private infertility center.


A 30-year-old nulliparous woman presented with PCOS and 1 year of infertility.


Conventional IVF was scheduled and a long-acting agonist protocol was selected.

Main Outcome Measure(s)

Maternal serum hCG levels and transvaginal ultrasound exams for the embryo’s well-being.


The hCG level was 11.6 IU/L on day 11 after the transfer of two blastocyst embryos, which was considered as either failing or extrauterine pregnancy. After blood titration, there were delayed hCG increases. A series of transvaginal ultrasounds also indicated a delayed but normal-appearing intrauterine pregnancy. A healthy baby boy was delivered at term by means of cesarean section.


A low initial serum hCG level may be associated with certain maternal or fetal characteristics and IVF treatment variables. Close conservative observation is warranted before undertaking any therapeutic intervention.

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