The Predictive Value of Early β-hCG Levels After Embryo Transfer in In Vitro Fertilization Treatment

BACKGROUND: Early serum beta-human chorionic gonadotropin (β-hCG) levels are commonly used to assess pregnancy viability following in vitro fertilization (IVF). However, their predictive value for live birth remains uncertain. AIM: This study evaluates the predictive value of early β-hCG levels on post-transfer days 12 and 14 in determining live birth outcomes after IVF. METHODS: A retrospective chart review was conducted on 755 women who underwent IVF between 2017 and 2023. Demographic, clinical, and laboratory data were collected. Serum β-hCG levels were measured on post-transfer days 12 and 14. Receiver operating characteristic (ROC) curve analysis determined optimal β-hCG cutoff values for predicting live birth. RESULTS: Among participants, 414 (54.8%) achieved live birth. Mean β-hCG levels on day 12 were significantly higher in the live birth group (554.5 ± 378.4 mIU/mL) compared to the non-live birth group (208.0 ± 162.5 mIU/mL, P < 0.001). On day 14, levels remained elevated in live birth cases (1466.8 ± 890.3 mIU/mL vs. 570.0 ± 452.8 mIU/mL, P < 0.001). The rate of β-hCG increase was also greater in the live birth group (P < 0.001). ROC analysis identified cutoffs of 205.5 mIU/mL on day 12 (72.4% sensitivity, 72.3% specificity) and 535 mIU/mL on day 14 (71.4% sensitivity, 71.3% specificity). CONCLUSION: Early β-hCG levels are strong predictors of live birth following IVF. Establishing clinical thresholds may enhance early pregnancy assessment and patient counseling.