# Tailoring clinical management after embryo transfer using β-hCG levels in resource-limited settings

## TL;DR

This study shows that measuring β-hCG levels 14 days after embryo transfer can help predict pregnancy outcomes and guide clinical decisions in low-resource settings.

## Contribution

The study identifies a β-hCG threshold of 468 mIU/mL as a reliable predictor of live birth with high sensitivity and specificity.

## Key findings

- Higher β-hCG levels correlate with increased chances of live birth but also higher risks of complications.
- A β-hCG threshold of 468 mIU/mL was found to have 75% sensitivity and 72% specificity for predicting live birth.
- Using β-hCG testing reduces the need for frequent monitoring, easing the burden on patients in resource-limited areas.

## Abstract

Cleavage-stage embryo transfers are often the best option for patients with limited oocytes or low fertilization rates due to medical or financial constraints. This study analyzed 424 women undergoing β-hCG testing 14 days after embryo transfer at a tertiary care center in India. Pregnancy outcomes were classified as no live births (biochemical pregnancies, ectopic pregnancies, miscarriages) or live births (single/multiple births). Higher β-hCG levels were associated with greater chances of live birth but also an increased risk of complications like preterm birth and preeclampsia, particularly in multiple pregnancies. A β-hCG threshold of 468 mIU/mL was identified as the optimal predictor of live birth, with 75% sensitivity and 72% specificity. Receiver operating characteristic (ROC) curve analysis confirmed its strong predictive value. By reducing the need for frequent monitoring, this single-test approach helps ease the emotional, financial, and logistical burdens patients face during IVF treatment. The study highlights β-hCG as a simple, cost-effective tool for providing early reassurance, guiding counseling, and personalizing follow-up, particularly in low-resource settings where access to fertility care remains challenging.