Defining the rise of serum HCG in viable pregnancies achieved through use of IVF

BACKGROUND: We aimed to characterize the rate of HCG rise associated with viable IVF pregnancies, and to evaluate the association between HCG rise and potentially influential factors. METHODS: We performed a retrospective cohort analysis of all viable pregnancies achieved through IVF at two centres between January 1999 and March 2004. RESULTS: Of the 455 pregnancies resulting in live births, 391 met inclusion criteria and contributed a total of 1052 HCG values. Using random effects models, the best pattern to describe the rise of log HCG was quadratic with the rate of increase slowing at 24 days post-oocyte retrieval. Limiting the analysis to measurements below the discriminatory zone, the linear model adequately characterized the profile. The average slope was 0.403, yielding a predicted increase of 1.50 (50% increase) in 1 day and 2.24 (124%) in 2 days. In the final model, absolute HCG values, but not rate of rise, were significantly higher for twins and triplets and significantly lower for patients with BMI>30 kg/m2. CONCLUSIONS: The HCG profile of viable pregnancies conceived with IVF is quadratic with an earlier plateau than has been reported for non-IVF pregnancies. The average rate of rise is comparable to previous estimates in symptomatic spontaneous conceptions.     

血清孕酮及绒毛膜促性腺激素的检测在早期先兆流产中的临床意义

目的 分析探讨怀孕早期孕妇的血清孕酮及绒毛膜促性腺激素水平在早期先兆流产中具有的临床意义和价值. 方法 选取孕龄6-9周的孕早期孕妇221例,根据妊娠的结果将其分为继续妊娠组92例、最终流产组61例和健康对照组68例,采用全自动化学发光免疫分析仪分别对血清中的孕酮P和绒毛膜促性腺激素β-HCG水平进行检测. 结果 孕6~9周继续妊娠组各孕周P及β-HCG水平均显著低于健康对照组,最终流产组各孕周P及β-HCG水平均显著低于继续妊娠组（P〈0.05）差异有统计学意义,孕酮水平变化同β-HCG,差异有统计学意义. 结论 孕6~9周时血清P和β-HCG水平检测是孕妇早期先兆流产判定的有效手段,两者联合应用对先兆流产的临床诊断具有重要意义.     

剖宫产瘢痕妊娠患者甲氨蝶呤胎囊注射联合B超监测下清宫术的疗效分析

目的 探究甲氨蝶呤胎囊注射联合B超监测下清宫术治疗剖宫产瘢痕妊娠患者的临床效果。方法 回顾性分析2014年10月至2017年10月安钢总医院收治的87例剖宫产瘢痕妊娠患者临床资料,按治疗方案不同分为对照组（n=43）与试验组（n=44）。对照组患者单纯采取甲氨蝶呤胎囊注射治疗,试验组患者采取甲氨蝶呤胎囊注射联合B超监测下清宫术治疗。对比两组患者的临床效果、月经恢复时间、包块消失时间、血人绒毛膜促性腺激素（HCG）转阴时间、阴道出血时间、住院时间及治疗前、治疗后2个月生活质量评分（SF-36）。结果 试验组治疗后总有效率（88.64%）高于对照组（67.44%）,差异有统计学意义（P<0.05）;与对照组相比,试验组包块消失时间、血HCG转阴时间、阴道出血时间、住院时间均较短,差异有统计学意义（P<0.05）;两组患者治疗后2个月SF-36评分均提高,且试验组提高水平高于对照组,差异有统计学意义（P<0.05）。结论 剖宫产瘢痕妊娠患者予以甲氨蝶呤胎囊注射联合B超监测下清宫术治疗可明显改善临床效果,缩短患者恢复时间,改善患者生活质量。     

Vascular cell adhesion molecule-1 in normal, failed, and ectopic pregnancy

PROBLEM: Vascular cell adhesion molecule-1 (VCAM-1) is involved in early pregnancy establishment. This study sought to determine whether soluble VCAM-1 (sVCAM-1) serum levels differ among normal, failed, and ectopic pregnancy, its capacity to serve as a marker for pregnancy viability or ectopic pregnancy, and its correlation with serum progesterone and beta human chorionic gonadotrophin (PHCG) levels. METHOD OF STUDY: Maternal serum samples were obtained from 20 women with ectopic, 10 with normal, and 10 with failed intra-uterine pregnancy, all of comparable gestational age. Samples were assayed for sVCAM-1, progesterone, and betaHCG by specific assays. RESULTS: The median serum level of sVCAM-1 was comparable between the three pregnancy types (normal: 578.3 ng/mL, range 434.4-699.5 ng/mL; failed: 567.8 ng/mL, range 401.9 669.5 ng/mL; and ectopic: 470.7ng/mL range, 328.2-1151.1 ng/mL). Serum levels sVCAM-1 were not significantly correlated with betaHCG or progesterone levels. CONCLUSION: sVCAM-1 is not appropriate to serve as a marker for pregnancy viability or ectopic pregnancy.     

妊娠中期血清AFP与HCG产前筛查唐氏综合征的研究

报道 8 5 0例妊娠中期血清采用 AFP与 HCG放射免疫技术测定法 ,产前筛查唐氏综合征的研究。经 9个多月的初步工作 ,现已筛查出 18例高危孕妇 ,并经羊水产前诊断确认 1例为唐氏综合征 ,行人工流产 ,避免了患儿的出生。研究证明筛查的优越性和实用性 ,对优生优育具有重要应用价值。     

不同稀释液对β- HCG 稀释检测的影响

目的：比较四种稀释液对高浓度血清β- HCG 稀释检测的影响,探讨电化学发光免疫分析时高浓度血清β- HCG 稀释检测的最佳稀释液。方法收集 l 例高值β- HCG 血清标本,分别用 HCG 稀释液、零值血清、生理盐水和蒸馏水进行稀释。稀释后测定结果与理论值进行相对偏差比较,并进行相关性分析。结果零值血清相对偏差最小。相关性最好：HCG 稀释液次之,生理盐水尚可,蒸馏水相对偏差最大。结论为保证检测结果的准确性,对高浓度β- HCG 样本稀释检测最好采用零值血清作为稀释介质,其次可以考虑用 HCG 稀释液和生理盐水,不宜使用蒸馏水作为稀释介质。     

控制性超促排卵治疗周期HCG注射时间的选择

对我中心1999年7月至2000年5月施行的182个体外受精－胚胎移植（IVF－ET）捉排卵周期,阴道超声监测卵泡发育以及血和尿LH峰的监测情况进行回顾性分析,发现注射HCG日妊娠组和非妊娠组间2个最大卵泡的平均直径及优质胚胎率有显著性意义（P＜0．05）,认为适时注射HCG是很重要的。     

Circulating levels of placental protein 12 and chorionic gonadotrophin following RU 38486 and Gemeprost for termination of first trimester pregnancy

First trimester termination of pregnancy was successfully inducedin ten patients with RU 38486 followed 2 days later by a prostaglandin(Gemeprost) pessary. Human chorionic gonadotrophin (HCG) valuesremained unaltered until after the abortion. The levels of placentalprotein 12 (PP12) showed an immediate and significant fall followingRU 38486, then rose to values substantially higher than thoseat the initial visit after 2 days. These findings show thatRU 38486 has a direct inhibitory effect on tissues producingPP12 and confirm the progesterone dependency of this protein     

Incorporation of Human Chorionic Gonadotropin Alpha-Subunit into Different Types of Granule in Stomach Endocrine Cells

In order to demonstrate the ultrastructural localization of the α subunit of human chorionic gonadotropin (hCG) in the stomach mucosa, an immunoelectron microscopic study was performed using formalin-fixed specimens. In pyloric glands, α hCG-positive granules were irregular in outline, with a mean area and maximum diameter of 2.857 × 10⁴ nm² and 218.4 nm, respectively. In fundic glands, the granules had a smoother outline and were larger in both area and maximum diameter (3.943 × 10⁴ nm², 246.8 nm) than those of pyloric glands (p <0.001). In the atrophic fundic glands of non antral gastritis, the αhCG granules showed a differece in shape; more elliptical granules appeared to be increased, as indicated by the higher value of the axial ratio (1.452) and lower value of D (1.862) (log₁₀ area ∞ D log₁₀ perimeter) compared with those in pyloric (1.231, 1.968) and fundic glands (1.148, 1.979) (p< 0.001). The a-subunit of hCG is thus Incorporated into different types of endocrine cell in pyloric and fundic glands, and the granule morphology appears to differ in hyperplastic αhCG cells of non-antral gastritis. Acta Pathol Jpn 39: 737-742, 1989.