HCG level on day 16 after replanting. Life after IVF transfer

Features of hCG after IVF: how it affects the onset and maintenance of pregnancy. HCG table by day after IVF: norms

Pregnancy is a state, each stage of which is clearly regulated by its own hormones. The process of gestation as a result - IVF - also needs hormonal regulation. Not always the mother's body is able to independently provide the necessary level of hormones.

Analyzes after IVF allow you to determine the growth rate of active substances, if necessary, correct them with drugs. But some hormones are an indicator of a normally developing pregnancy. For example, hCG after IVF in terms of growth rates can tell about the course of gestation, the likely threat of interruption, or, for this, it is enough to compare the results with the table.

• The role of hCG in IVF
• The first signs of pregnancy after IVF before hCG
• Allocations
• What is the dynamics of hCG after embryo transfer
• Interpretation of analysis results
• HCG table by day after IVF: normal
• What does low hCG mean?
• Causes of high hCG levels in the early and late stages
• Ultrasound control
• Prescribing hCG in injections after embryo transfer in IVF protocols

The role of hCG in IVF

For the first time, a woman who decides on artificial insemination encounters human chorionic gonadotropin when ovulation is stimulated. This procedure is performed for those who have regular unprotected sex, many women over 35 years of age and those who, according to the results of ultrasound, have abnormal development of the follicles or corpus luteum.

When stimulating ovulation, only an injection of hCG can be used. It is administered if, according to the results of ultrasound, the follicle matures, but its shell cannot rupture on its own and passes into or regresses.

Another stimulation scheme involves taking Clomiphene preparations, which stimulate the production of FSH and LH. These hormones ensure the maturation of the follicles. When, according to ultrasound, they reach a size of 17-18 mm, they give an injection of hCG. This hormone provokes the maturation of oocytes, the rupture of the membrane and the release of the egg. 24 hours after the injection, the woman is ready to produce and collect eggs. If the moment is missed, the follicle will rupture on its own and the oocytes cannot be collected.

Some protocols provide for the re-introduction of hCG if the size of the follicles has reached 20-25 mm, and the rupture has not occurred. Sometimes a hormone is needed to support the corpus luteum. But the dosage of such injections is very small - 300-1500 IU. An overdose of the drug, frequent use leads to early menopause.

Signs of pregnancy after embryo transfer before hCG analysis

An analysis for hCG is prescribed after 14 days. But many women, even before a blood test, feel the symptoms and the first signs of pregnancy after IVF:

• irritability, sudden mood swings;
• sleep disorders;
• headache, fatigue;
• that appear earlier than with natural fertilization;
• engorgement of the mammary glands;
• pain in the pelvis, in the ovarian region;
• lowering blood pressure;
• tides.

Allocations before hCG analysis: menstruation or implantation bleeding

Some may experience spotting. This is implantation bleeding, which occurs as a result of the dissolution of the endometrial vessels by the embryo. It should not be plentiful and long. But it is possible to accurately establish the fact only by the results of ultrasound and analysis for hCG.

Embryo implantation does not occur simultaneously with its replanting in the uterus. This usually takes up to 6 days. But sometimes a fetal egg cannot find a suitable place in the wall of the uterus for a long time, then it happens 10 days after planting. It does not affect this in any way, but hCG will also begin to rise later.

In vitro fertilization - for many couples, this may be the last chance to have such a desired child. One of the most important indicators that pregnancy is developing normally is the hCG hormone. DPP - this indicator is also very important in assessing pregnancy after IVF. Let's see what is hidden under these abbreviations.

IVF - what's the point

Of course, everyone knows that in order for a child to appear, a sperm cell (male reproductive cell) must meet and fertilize an egg (female reproductive cell). After that, it is introduced into the mucous membrane of the uterus, undergoes a series of changes that occur over nine months, after which a child is born. Often the cause of infertility is the inability to carry out these two processes in vivo. That is, for a number of different reasons, spermatozoa are not able to fertilize an egg on their own, or an already fertilized egg cannot reach the uterus or be introduced into it. But at the same time, a woman is quite capable of bearing a child. And then the doctors come into play. Taking the germ cells of both parents, they carry out and introduce the resulting embryo into the endometrium. Of course, this description is very schematic. Thus, the process of conception is somewhat simplified, and many couples get a chance.

DPP

A fertilized egg (embryo) is implanted into the uterus on the 3rd or 5th day after fertilization. At the same time, during the procedure, not one, but two embryos are introduced at once. This increases the chances that pregnancy will still occur. However, there is a high risk that you will have to repeat this procedure several times. It happens that the embryo takes root not even on the second, but on the fourth or fifth attempt. The abbreviation DPP refers to how many days have passed since the introduction of the embryo. This date is very important, to make sure that the pregnancy has come, you need to wait for 14 DPO. HCG, the level of which is measured precisely at this time, is the main marker of this event.

HCG hormone

Human (hCG) is normally determined only in the body of a pregnant woman. The egg begins to produce it, but since it enters the body of a woman already fertilized, the appearance of this hormone in a blood test or in the urine means that the embryo was successfully implanted. It is believed that pregnancy has occurred if hCG at 14 DPP of five days (embryos that were introduced on the fifth day after fertilization occurred) is at least 100 mIU / l. If the indicators are 25 mIU / l and below, then, most likely, the procedure will have to be repeated. However, low values ​​​​of this analysis can also be in the event that not enough time has passed after the introduction of the embryo, for example, hCG is determined at 12 DPP.

What does hCG show

Chorionic gonadotropin is also called the hormone of pregnancy. Immediately after fertilization, it prevents the corpus luteum from regressing and stimulates the synthesis of hormones such as estrogen and progesterone. In the blood serum, hCG is determined immediately after the egg is introduced into the uterine mucosa. After that, its concentration begins to grow rapidly. In the normal course of pregnancy, it doubles every two days. The maximum hCG (DPP) is recorded at the tenth week. After that, the level of this hormone gradually decreases over 8 weeks, and then remains stable until delivery.

It should be noted that doctors closely monitor the level of the hormone in the blood serum and the ratio of hCG - DPP also because significant deviations of this indicator from the normal range often become a marker of serious pathologies both in the mother's body and in the development of the fetus.

Methods for determining chorionic gonadotropin

In most women, after successful IVF, changes in hCG levels begin to be tracked as early as 9-14 days. In order to identify its appearance, it is not even necessary to donate blood. Pregnancy tests work on the principle of detecting its presence in the urine. Of course, they do not indicate the exact numbers and amounts of hCG on the DPP of five days or three days, but its very presence most likely indicates a pregnancy. To get a more accurate result, a woman donates blood. If, during a normal pregnancy, blood is donated for hormones during screening, which is carried out in the first trimester, then during in vitro fertilization, for a more informative picture, gynecologists recommend doing this every 2-3 days after the implantation of the embryo. The results obtained are compared with a table that shows the minimum, maximum and average values ​​​​of hCG at a certain period of DPP.

HCG norms

Like all indicators, the level of hCG can vary within certain limits. Most often, the table shows data on fluctuations in its level by week of pregnancy. There are also tables showing indicators of the increase in the level of the hCG hormone by day. They are most relevant for those who have undergone IVF. The table below shows only the average values ​​per day after implantation (DIP) for embryos that were implanted 3 and 5 days after fertilization.

As you can see, hCG at 7 DPP of five days is 45 mIU / l, but normally its indicators can range from 17 to 65 mIU / l. On the same day, the average for a three-day embryo will be 18, and the normal range will be 8-26 mIU / l.

Reasons for the increase in hCG

As already mentioned, hCG is not only an indicator that pregnancy has occurred, but also allows you to control its course. In the event that the level of this hormone is not much outside the normal range, then this is not given much importance, but if the hCG DPP values ​​do not correspond significantly, then this can be a signal of the presence of serious pathologies of both the mother and the fetus. A significant increase in this indicator can lead to:

• chromosomal abnormalities in the development of the fetus (Down syndrome);
• trophoblastic tumors;
• endocrine disorders (diabetes mellitus);
• taking medications containing gestagens;
• multiple pregnancy.

Reasons for the decrease in hCG

A low level of charotic gonadotropin can be recorded in the following cases:

• threatened abortion;
• frozen pregnancy;
• fetal malformations;
• prolongation of pregnancy;
• placental insufficiency;
• ectopic pregnancy.

Elevated hCG on DPP. Twins

With IVF, in order to increase a woman's chances of becoming pregnant, two embryos are implanted at once, but this often does not guarantee the success of the procedure. However, there are also such precedents when both take root at once. In this case, hCG levels can increase by 2-3 times. This is due to the fact that it is produced not by one placenta, as is the case with a singleton pregnancy, but by two at once. For example, if the level of hCG at 16 DPP of five days averages 1960 mIU / l, then for twins the normal indicator will be 3920 mIU / l and above.

HCG indicator in the diagnosis of fetal anomalies

Of course, pregnancy is an important and expected event in the life of any woman, but it happens that it brings not only joy, but also experiences. Against the background of stress, ecology and other factors that do not have the best effect on the emerging life, there is a risk of developing pathologies. The modern level of medicine allows many of them to be diagnosed and even corrected at an early stage. It is for this that mandatory screenings are carried out in the first and second trimesters of pregnancy. which is usually carried out for a period of 10-14 weeks, includes ultrasound and control of the level of hCG and PAPP-A hormones. Screening of the second trimester is carried out at 16-18 weeks. In it, along with ultrasound, a triple test is performed (hCG, AFP, estriol). The data of the second screening make it possible to determine the presence of pathologies with a high probability. In the event that, against the background of low levels of AFP and estriol, the level of hCG significantly exceeds the norm, it is highly likely that the fetus has Down syndrome. or Patau may be suspected when all three markers are low. Relatively normal values ​​of chorionic gonadotropin with low AFP and estriol may indicate Turner syndrome.

All predictions are made based on the individual characteristics of the ongoing pregnancy - the age of the mother, her weight, the presence of bad habits, comorbidities, diseases in children born in previous pregnancies. If the examination revealed even minor deviations from the norm, the woman is necessarily sent for a consultation with a geneticist.

How to take an analysis

To analyze for hCG, you need to donate blood from a vein. It is better to do this in the morning and strictly on an empty stomach. In the event that you have to take it during the day, you need to refrain from eating for at least 6 hours. In the event that you are taking any drugs containing hormones ("Pregnil", "Horagon"), you need to warn your doctor about this in advance.

In order for the laboratory test to be more informative, it is better to do it no earlier than 3-5 days after the delay in menstruation. In the case of IVF, the diagnostics carried out on the 14th day after the procedure will have the most accurate data.

HCG is determined to diagnose pregnancy, identify its exact period and check the condition of the child. When taking a blood or urine test, you can quickly clarify this indicator. It is advisable to do this regularly so as not to miss important changes in the condition of the fetus.

HCG stands for Human Chorionic Gonadotropin. It is produced by the tissues of the fetus when it attaches to the wall of the uterus. After fertilization, this fact occurs on the 4th day. When an embryo transfer occurs, a woman has a great responsibility, because of which changes are made to her life. It is imperative to take an hCG test, which helps to quickly identify the hormones produced by the embryo, which allows you to quickly recognize pregnancy and monitor the baby's condition.

How to do it and why?

To detect the hormone produced by the embryo, a certain time must necessarily pass. Usually the first test is scheduled for a period when exactly 14 days have passed after IVF. The hormone level is calculated according to a special table. This analysis is performed to diagnose pregnancy, monitor the condition of the fetus and timely detect pathologies of its development.

HCG table

The table for determining hCG is necessary to reconcile the indicators of analyzes with the norm. The numerical values ​​refer to one ml of blood plasma. If the mark is above 25 mU / ml, then pregnancy has occurred. With the help of the table, you can track the growth dynamics of the baby. Up to 8-9 weeks, a constant increase in the level of hCG is determined. Upon reaching this time, this indicator gradually slows down, and after a few weeks it progresses again.

How to use the hCG table?

1. Determine the day of blood donation after the transfer and compare the results for this line. It is necessary to calculate the days from the date of the puncture to the time of the blood test.
2. There are two separate columns for 3-day and 5-day embryos. It is necessary to choose the one that corresponds to the fetus introduced to the woman. It can be used to determine the age of the embryo.
3. The three columns on the far right indicate the minimum, average and maximum hCG levels during a normal pregnancy. A slight deviation from the norm may indicate an error in the calculations, and significant differences in the indicators mean that you need to seek medical help in a timely manner to diagnose possible pathologies.

How to live after embryo transfer so that the hCG level is favorable?

1. Be sure to maintain a sedentary lifestyle. The daily routine should be moderate, and all movements and emotions should be calm.
2. The first day you need to live completely in a horizontal position, that is, immediately after the procedure, the woman comes home, lies down on the bed and stays in bed as long as possible. It is advisable not to burden yourself with household chores or any other work. You need to arrange in advance for help around the house or a replacement at work. At this time, you should not swim.
3. You can not resort to any physical activity. Even a small charge can interfere with the most favorable outcome of IVF. Work in the garden or participation in sports competitions are excluded.
4. Do not lean too hard or sharply. Weight lifting is completely prohibited. Care must be taken not to habitually pick up even not very large objects, for example, full pans, as this can lead to a miscarriage.
5. If possible, you should avoid car trips as a driver, so it is advisable to take an escort with you to the procedure.
6. Slow walks are recommended. For greater benefit, a woman should be active in the fresh air, and jumping, running, and even sudden movements should be avoided, especially in the first days after IVF.
7. You can't walk down the street if it's cold. There is an alternative, which consists in the most dense and solid clothes, but there is always a risk that a woman will even be slightly blown, which can lead to infections or an inflammatory process in the body that has just undergone an IVF procedure.
8. Overheating is contraindicated. Do not take a warm or hot bath. It is also forbidden to visit the bath or sauna. It is advisable not to perform these actions for the entire duration of the pregnancy.
9. It is not recommended to have sexual relations with a partner for a week, preferably two after IVF.
10. Ensuring adequate sleep for at least 8 hours a day.
11. Refusal of tight clothing will increase the chances of successful fertilization during IVF. You need to wear only those things that have an extended, flared style. This point is not fundamental, but many doctors argue that the right clothing increases a woman's chances of a favorable pregnancy.

A balanced diet is maintained. Enough food should be consumed, but it should not be too much. It is necessary to ensure that all products are of high quality and healthy, completely abandon preservatives and other food additives.

Only natural products are needed, as they quickly raise the overall tone of the body, activate vitality, which greatly increases the likelihood of a successful pregnancy, so it is advisable to eat well long before IVF, but you should especially monitor the diet immediately after it.

Especially at this time, protein is useful. Usually it is meat or eggs. Broths are perfectly digested, but they must be cooked only from fresh products purchased at a trusted outlet. Poultry meat and natural fish are well suited for strengthening the body, preferably without heat treatment, that is, smoked or salted.

Drinking at least 2.5 liters. It is advisable to use not only water, but also vitamins, therefore natural juices, compotes, tea are recommended, but only green is allowed. Also, there are no restrictions on the amount of dairy products. Usually women consume kefir and yogurt, as they are the most favorable for the stomach.

Excellent help to keep the body in good shape and create a favorable environment for pregnancy, fresh vegetables and fruits, which contain fiber. Apples, apricots and plums are most useful and accessible to the majority of the population. Allowed the use of vegetable salads in large quantities, it is recommended to fill them with oil. If IVF is done in winter, and it is not possible to get good products, you need to use prunes. To do this, it is prepared or purchased in advance.

It is undesirable to use beans, peas and other legumes. You should also stop eating sour cabbage. Heavily smoked food is also not recommended. You can’t eat mushrooms, as there is a possibility of developing their intolerance, and if purchased at unverified points of sale, even poisoning.

You can not eat flour and sweet. If a woman becomes pregnant, her appetite is guaranteed to increase. All excess calories eaten without benefit, or foods that contain a large amount of poorly digestible fat, are very quickly deposited, further interfere with the movement of the pregnant woman, and lead to weight gain. Such products include not only buns and cakes, but also chocolate. It can be consumed, but it is advisable to refrain from its low-quality varieties or a large amount of this substance.

Features of the behavior of a pregnant woman before the hCG test

1. Implantation of the embryo, which is introduced into the body during IVF, takes 40 hours. It is at this time that you need to protect yourself from various negative influences so that there is a guarantee that the fetus will take root in the body.
2. It is impossible to communicate with sick people, especially if they suffer from a viral or bacterial infection, even of a chronic nature. To ensure that you do not get infected, you should not appear in public places.

Hormonal Support

Many women during normal pregnancy find small spotting, complain of moderate abdominal pain, and also observe unusual changes in hCG levels. This is usually due to the fact that after this procedure, hormonal therapy is specifically prescribed to maintain balance in the body. Most often, the formation of unpleasant symptoms is affected by drugs such as Utrozhestan, Duphaston, as well as the hormone progesterone in micronized form.

To avoid unpleasant phenomena, you need to consult a doctor for an individual selection of the dosage of progesterone. It is necessary to choose the optimal scheme for its administration. Features of the action of these drugs are manifested depending on the general condition of the woman's body. You can not change the dosage on your own, so that sharp jumps in the hormone do not harm the body.

Video - blood test for hCG

Normal sensations that appear after IVF with increasing hCG

Usually specific sensations do not appear too sharply. Most patients do not have them. Any sensations, such as dizziness, craving for sleep, or breast swelling, which is characteristic of the premenstrual period, cannot clearly indicate the perfect fact of implantation. Even if they appear in women on the first day after IVF, this indicates their psycho-emotional arousal. The fact of the beginning of pregnancy cannot be physically felt.

The hCG test is usually done 2 weeks after IVF. Only then can you determine if you are pregnant or not. In cases where the attempts were unsuccessful or, on the contrary, the fetus appeared, this will become clear only when the test results are received. Any signs or their absence cannot indicate the results of fertilization. Usually, the state of health remains normal, does not differ from what the woman had before IVF. In case of strong emotional overstrain, any deviations are possible that can damage the fetus, provoking a miscarriage, so it is advisable to refrain from listening to your feelings.

When the embryo transfer is completed with successful fertilization, the woman, after some time, begins to notice signs of pregnancy. Usually there are no additional signs during IVF, that is, they do not differ from those that appear during pregnancy as a result of natural fertilization. If there are any pathological processes, then negative signs appear.

In order not to miss any changes in the body, it is advisable to regularly change the general and basal temperature. Sometimes after IVF there is a change in basal temperature to a higher side. This phenomenon is physiological. Such changes are manifested due to hormonal changes in the body. Sometimes there is a decrease in basal temperature. If the mark drops below 370 ° C, then it is necessary to consult a doctor in order to exclude the development of pathologies.

A few words in conclusion

A routine hCG test should be done regularly. Primarily, it helps to confirm the presence of pregnancy in the early stages, and then it is needed to monitor its passage. In order for the pregnancy to proceed without complications, one should not only control hCG, but also adhere to the general rules for maintaining the health of one's own body, creating favorable conditions for the growth and development of the fetus.

They say the biggest adrenaline rush isn't the roller coaster, it's waiting for the pregnancy test result. This is especially true for the patient after IVF. Embryo transferred. A lot has already been done, a lot of effort, time and money have been spent. Ahead of two weeks of endless waiting ....
What happens during this period? The body has already gone through a lot. The prescribed drugs (primarily progesterone and its derivatives) are designed to create optimal conditions for pregnancy. There are no other, more effective, medicines for this stage yet. It remains to be patient and wait.

At this time, moderate cramping pains, scanty spotting or even light bleeding, slight bloating, general fatigue and soreness of the chest may disturb. Symptoms should not increase. Their presence (as, indeed, absence) does not mean that pregnancy has not occurred.

Please note, if after the completion of the IVF program there is excessive, progressive abdominal distention and tenderness, shortness of breath, chest pain, or impaired urination, contact your clinical team immediately, as these are the first signs of hyperstimulation syndrome and intensive care is likely to be required.

But even if everything is fine, painful doubts, forebodings do not leave:

Please tell me if the absence of discharge or any other symptoms does not indicate that the implantation did not take place again ?? Today I have 3DPP of two five-day days, in terms of terms, it should already happen. The first 2 days my lower abdomen ached, today I feel like an astronaut. I am very worried that there are NO sensations AT ALL .......

Help with advice: transfer of 3 good quality blastocysts. here is my hCG 5DPP - 2.8 (already decided that the flight and all the appointments were carried out mechanically), 12DPP - 118.8 (I was very surprised), 14DPP 253.1. I do not fit into the table of hCG norms. what can i do to get my baby out? This is already the 8th transfer.

Tell me, please, if at 7 DPP three-day hCG is negative, is it possible to hope for pregnancy?

Questions like this come up frequently. In this connection, I would like to talk a little more about the early diagnosis of pregnancy, how hCG grows, and whether it is worth making any predictions based only on its values. Are laboratory studies of hormone levels and blood clotting indicators justified at this stage?

I'll start with the main one: hCG (human chorionic gonadotropin)- a special hormone of pregnancy. It is an important indicator of the development of pregnancy and its deviations. Chorionic gonadotropin is produced by cells of the germinal membrane immediately after its attachment to the wall of the uterus (implantation). Based on the figure obtained, the doctor determines the presence of fetal tissue in the body, and hence the onset of pregnancy in a woman.

The level of hCG in the blood can be determined as early as 6-8 days after implantation, which suggests the onset of pregnancy (the concentration of hCG in the urine depends on the sensitivity of the test and usually reaches the diagnostic level 1-2 days later than in the blood serum). It is worth noting that the timing of the appearance of the first positive hCG values ​​and the rate of its increase are similar, but in 15% of cases they do not fit into generally accepted norms and require more careful monitoring to make a correct diagnosis.

In 85% of cases normal course of pregnancy in the period between 2 - 5 weeks, accompanied by a doubling of hCG every 72 hours. The peak concentration of hCG occurs at 10-11 weeks of pregnancy, then its concentration begins to slowly fall. This is the result of the work of the "embryo-placenta" complex, it is the placenta that begins to independently maintain the necessary hormonal background. By this time, the body no longer needs a high content of hCG.

Increasing the level of human chorionic gonadotropin during pregnancy can occur with:
normal uterine pregnancy (individual characteristics in 10 - 15%)

• multiple pregnancy
• toxicosis
• maternal diabetes
• some genetic pathologies of the fetus
• trophoblastic disease
• incorrect gestational age
• taking synthetic gestagens (drugs from the progesterone group)

Its elevated values ​​can also be seen within 7-10 days after an interrupted pregnancy (medical or spontaneous abortion). But the concentration of the hCG indicator in dynamics in these cases does not increase, but more often falls.

Low human chorionic gonadotropin may indicate a miscalculation of the gestational age or be a sign of serious disorders, such as:

• ectopic pregnancy
• non-developing pregnancy
• fetal growth retardation
• risk of spontaneous abortion
• some other rarer conditions.

It is important to understand that a decrease in the value of hCG in repeated studies says only one thing: the development of the fetal egg has already stopped, it is impossible to resuscitate it. The exception is a laboratory error (not often, but it happens).

Optimal terms for determining the level of hCG 12-14 days after the transfer(lower chance of error). If a two-week wait is insurmountable for you, you can donate blood earlier, starting from the 7th-8th day, but having received any (positive or negative) value, do not draw conclusions until you repeat the analysis 2-3 times in dynamics.

HCG values ​​​​depending on the gestational age are in many laboratory tables, I will not repeat them here. But it is important to consider the following:

• From 0 to 10.0 mIU / ml on days 13-14 after transfer - no pregnancy.
• 10.0 to 25.0 mIU/mL is questionable and needs to be repeated, implantation is debatable.
• From 25.0 mIU ml and above a positive value, an indicator of implantation.
• In the study on the 16th day after the puncture, the level of hCG in the blood above 100 mIU / ml (for embryos of the 3rd day) or 130 mIU / ml (for the embryos of the 5th day) indicates a high chance of a successful pregnancy, while while at lower values, the likelihood of uterine progressive pregnancy is not high.
• Any positive hCG figure dictates the need keep previously assigned support, especially progesterone preparations (krynon, progesterone, utrogestan, duphaston and others). In controversial cases (the figure is below the average, there is bloody discharge from the genital tract, etc.), it is necessary to plan repeated determinations of hCG every 4-5 days. With an increase in the value of hCG, one can definitely talk about a progressing pregnancy, but an ectopic pregnancy cannot be ruled out.
• With a progressive decrease in hCG levels, maintain maintenance therapy is not worth it. This will only increase the time of uncertainty and vain hopes. The most common causes of non-developing pregnancy are genetic disorders of the fetus. It is usually not possible to save a pregnancy with severe genetic abnormalities. And is it worth it? The withdrawal of maintenance therapy should be discussed with your gynecologist.
• More specific information about the onset of pregnancy can only be given Ultrasound of the pelvic organs, which can be scheduled no earlier than 20-22 days after the transfer.
• The dynamics of the increase in hCG can only be assessed when lack of support for hCG-containing drugs(pregnyl, chorionic gonadotropin, horagon and others). A trace concentration of externally administered hCG persists for 5 to 15 days. depending on the dose received and the individual characteristics of the organism. A sufficient number of studies have been published showing that the appointment of these drugs does not affect the prognosis, but makes it much more difficult to evaluate the results obtained.
• The level of hCG after embryo transfer of the 5th day is often slightly higher than after the transfer of the 3rd day, and practically does not depend on whether the transfer was fresh or cryo.

Another "fashion theme" - control of blood hormone levels in the period after the transfer in order to correct support drugs.

I want to get a consultation, I have 18dpo, hcg 970, support: duphaston 2tab 3 times a day, divigel 2g. Folio, passed estradiol - 725, progesterone -15.6 ... Tell me, is there enough support? And are the hormones normal?

***

Help me understand, 3 dpp blastocysts, today I passed progesterone 105.0 nmol / l (1 trim.: 29.6 - 106), estradiol 68 pmol / l. In support of ingest 2.5.% 2 p. per day, krynon at night, proginova 0.5 tablets per day. Is estradiol low? Perhaps you need to increase the support for proginova?

The initial idea looked logical: you determine the level of hormones (progesterone and estrogens) in the blood and, knowing their norms, adjust the medication prescriptions, like on a scale, adding a deficiency. These recommendations existed for some time in many manuals. But in practice, everything turned out to be much more complicated.

Firstly, the laboratory values ​​of the level of hormones during repeated studies in the blood vessel and in the uterine vessels (obtained during surgery) turned out to be different. The concentration of hormones in the uterine tissue was much higher.

Secondly, the production of hormones is pulsating. One secretory impulse takes 60 to 90 minutes. Do not take the same analysis repeatedly during the day, to calculate the average concentrations?

Thirdly, the level of hormones is additionally maintained by vaginal forms of gestagens, which have a slightly different chemical formula than progesterone known to us. That is, they are in the blood, but they are not determined in the analysis (another formula).
Therefore, laboratory testing of progesterone levels is of limited clinical value, as does not reflect its true concentration in the uterine vessels and is not a reason to change support. It is impossible, looking at the calm water surface near the coast, to estimate the speed of the river flow in the fairway.

At the later stages of pregnancy, when the "fetus-placenta" complex is included in the work, the concentration of progesterone can be one of the indirect signs of the progression of uterine pregnancy. But by this time, more reliable information can be obtained already during the ultrasound.

The determination of estrogen to assess the chances of pregnancy is even less promising. A high concentration of estrogens in the blood indicates only the severity of the hyperstimulation syndrome. Correlation between the value of estrogen and the frequency of pregnancy is not shown. In addition, the introduction of estrogens from the outside in the period after the transfer is far from always justified.

I’ll write a little more about the myth about “ thick blood«:

I had a transfer of 2 x five day old blastocysts. On the third day after the transfer, I passed the D dimer, the result was 2121.6 ng / ml !!! And on the fourth I passed RFMK, the result was 12 mg / dl (the norm is 0.00-4.00). I take fraxiparine 0.3 2 times a day and take thromboass 100 mg. Could you please tell me whether it is possible to indirectly consider that implantation has occurred based on such indicators? And why are such high rates dangerous?

Please tell me how often do you need to monitor the D dimer after the transfer? And in general, is it advisable to do this? For some reason, doctors have an ambiguous opinion about high rates ... Some say that this is normal ... Others that it is urgent to change therapy, which is very dangerous ...

The opinions of doctors in assessing this factor are indeed ambiguous. In different clinics, one can hear directly opposite recommendations on the significance of altered hemostasis parameters in the ART protocol. This introduces confusion, misunderstanding, who is right, is it important to “monitor hemostasis” after the transfer? Does the appointment of low molecular weight fraxiparins affect the final result?

There are always controversial topics in science. This is one of them. The position about the absence of influence of fluctuations of some values ​​of the coagulation system on the onset of pregnancy is close to me. An increase in a number of indicators of the hemostasis system is a kind of “patches” for the repair of blood vessels, protection against obstetric bleeding.

Studies show that the frequency of thrombophilia among women in need of IVF is the same as among absolutely healthy women - about 7%. During IVF in women with thrombophilia, the birth rate was the same (60.8% after 6 cycles) as in women without thrombophilia (56.8% after 6 cycles) - this means that the analysis for thrombophilia before IVF is not informative, the detection and treatment of thrombophilia in IVF does not affect the prognosis. In addition, many external factors can contribute to “hemostasis disorders”: ovulation stimulation, follicle puncture, multiple pregnancy, and much more. Today, there are no absolute norms for coagulation parameters for various conditions (except for assessing baseline indicators outside of stimulation and pregnancy). In this connection, I am sure that “monitoring of hemostasis” and the appointment of expensive fraxiparins, most likely, is only of commercial interest.

It is quite natural that every girl with the onset of a certain age wants to experience the happiness of motherhood. Unfortunately, it is not always possible to get pregnant naturally, which is facilitated by various negative factors.

Fortunately, now you can make your dream come true by using in vitro fertilization. In this case, an egg is placed in the woman's uterus, the fertilization of which was carried out under artificially created conditions.

It is no wonder that such a pregnancy requires supervision by the medical staff. And special attention in this case is paid to control the level of hCG. How does hCG increase after embryo transfer, and what can its indicators indicate?

Chorionic gonadotropin is the most important hormone, the production of which is carried out immediately after the embryo is placed in the uterine cavity. At the same time, at first, it is synthesized by the chorion - a protective shell in which the embryo is located.

At the beginning of the next trimester of pregnancy, the membrane is converted into the placenta, which continues to produce hCG, supporting the life support of the unborn baby. A significant increase in the hormone is observed a couple of weeks after the fertilization of the egg. It was at this time that they began to track the dynamics of hCG after IVF.

HCG levels are monitored throughout pregnancy. This hormone is a marker that allows early detection of deviations in the development of the fetus and possible deviations during pregnancy. It is especially important in in vitro fertilization, since in this case the risk of rejection of the fetus by the mother's cells increases significantly.

After embryo transfer, hCG values ​​that exceeded 1000 mU / ml already allow us to examine the fetus in more detail using ultrasound.

Each person is inseparable from chorionic gonadotropin, because in any organism, both in women and in men, it is produced by the pituitary gland. However, its level in the normal state ranges from 5 to 15 mU / ml.

On what day after embryo replanting does the active growth of hCG begin? This process begins on average in 5-6 days. A rapid increase in the level of hCG after IVF occurs from the second week, provided that the artificial insemination procedure was successful. Up to 15 weeks after IVF, hCG during pregnancy continues to grow, and then the increase slows down, resuming only by 22 weeks.

The success of the embryo replanting is judged by the results of a blood test taken from the expectant mother. And the hCG table after the transfer of fertilized eggs by weeks helps to compare the results with normal indicators.

It should be borne in mind that the data of the hCG table after IVF are only an approximate guideline, and small deviations cannot indicate the presence of a pathology.

But maximum control over the development of the fetus allows you to carry out the level of hCG growth by day. For this purpose, women are advised to donate blood every 2-3 days.

The results of the analyzes can be compared with the hCG table after IVF by day.

In the process of in vitro fertilization, four or five embryos are usually placed in the uterine cavity. One or two of them may take root. It is possible that all of them will fully develop. In this case, the extra embryos are removed from the woman's body and frozen. In the future, with an unfavorable course of pregnancy, cryotransfer of already grown embryos can be carried out.

But some women agree to bear several babies at once. And this factor must be taken into account, referring to the hCG indicators on the days after IVF. In multiple pregnancies, normal hCG increases by day after embryo transfer in proportion to the number of fetuses.

Stories with happy endings

Despite the assurances of doctors about the indicativeness of tests for the value of hCG, there are real examples confirming that low hCG after IVF is not always a pathology. This result, rather, is a feature of the body of every woman, so the hCG growth table is not indicative.

The first case occurred with a woman who was planted with two five-day pills. On day 8, the hormone level is 1.32, on 9 DPP it is slightly higher than 5.6, as a result of which the doctor recommended the abolition of hormonal support for pregnancy, considering it failed. Despite this, the woman believed in a miracle and did not refuse to take the drugs prescribed to her.

On the 10th day, practically nothing had changed, and after evaluating the result of the analysis the next morning, the doctor expressed a suspicion of an ectopic pregnancy, and that further medication would lead to the support of a pathological pregnancy.

At 14 and 16 DPP, the hCG results were 74.3 and 132.7, respectively. And on the 18th day, an ultrasound examination was performed, according to the results of which a fetal egg was not found in the uterine cavity.

The next ultrasound was performed on the 22nd day after transplantation. Preliminary hCG indicators gave a result equal to 1152.82. And this norm was finally confirmed by ultrasound, which showed that one fetal egg is in the uterus.

Subsequently, the level of the hormone was within the normal range, and the heartbeat of the embryo was detected at 32 DPP. At the same time, throughout the pregnancy, uterine bleeding was repeatedly observed, which was caused by taking hormonal drugs.

In another case, a woman was also planted with two five-day babies. She then tracked IVF results by day.

On the 7th day after infusion, the result seemed to be hopeless, since hCG was at the level of 88.6. Two days later, it increased to 412, and the rapid test was reassuring with only a slightly visible second line. HCG on day 14 is 840.5, and on day 17 there is one fetal egg in the uterus, which was confirmed by ultrasound. At 25 DPP, there are already two five-day weeks, and two heartbeats are heard on ultrasound.

You need to use the hCG table after IVF by day, but you should not take these figures as a dogma. It should be borne in mind that norms are calculated differently in each laboratory. In addition, the rate of the hormone in the blood of a woman depends on many factors, including the date elapsed from conception, age, body weight and genetic predisposition. Therefore, it is important to endure all adversity without falling into a panic that can harm the unborn baby.

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