Early beta-human chorionic gonadotropin trends in vanishing twin pregnancies

Vanishing twins demonstrate significantly lower early b-hCG level increases than normal singleton or twin pregnancies; increases, however, are within clinically normal limits. Abnormal early b-hCG level increases should not be attributed to a vanishing twin.

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Authors

Paula C. Brady, M.D., Katharine F. Correia, M.A., Stacey A. Missmer, Sc.D., Mark D. Hornstein, M.D., Sara E. Barton, M.D.

Volume 100, Issue 1, Pages 116-121, July 2013

Abstract

Objective:

To describe the early β-hCG trends in vanishing twins compared with normally progressing singleton and twin pregnancies.

Design:

Retrospective cohort study.

Setting:

University-based infertility clinic.

Patient(s):

Women undergoing fresh IVF/intracytoplasmic sperm injection (ICSI) cycles between 1998 and 2010.

Intervention(s):

Early β-hCG level increase in vanished twin pregnancies was compared with the level increase in normally progressing singleton and twin pregnancies.

Main Outcome Measure(s):

Two-day percent increase in β-hCG level.

Result(s):

Pregnancies with vanishing twins demonstrated a significantly lower mean 2-day percent increase in β-hCG level than singletons and twins (114.3% vs. 128.8% and 125.4%, respectively). Vanishing twins arresting at earlier developmental stages demonstrated significantly further reduced β-hCG level increases. Infrequently, all groups had β-hCG level increases less than previously established clinical thresholds that led to a live birth.

Conclusion(s):

Early β-hCG level increases are slower in vanishing twins than in singleton and twin pregnancies, with the slowest increases seen when the spontaneous fetal losses occur at earlier developmental stages. All increases, however, are within clinically accepted normal limits. Therefore, abnormal β-hCG level increases should not be attributed to a vanishing twin. Of note, an abnormal β-hCG level trend—even an initial decrease—does not preclude live birth, even in a singleton pregnancy.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00403-2/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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