What is the norm of hCG in IVF? DPP - what is it. Table of hCG after IVF standards

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

ECO - what is the point

Of course, everyone knows that in order for a child to appear, the sperm (male sexual cell) must meet and fertilize the egg (female sex cell). After that, it is introduced into the lining of the uterus, a number of changes take place during the course of nine months, after which a child is born. Often the cause of infertility is the inability to perform these two processes in vivo. That is, for a number of different reasons, spermatozoa can not self-fertilize an egg, or a fertilized egg can not reach the uterus or penetrate into it. But at the same time a woman is quite capable of bearing a child. And then doctors come into business. By taking the sex cells of both parents, they perform artificial insemination and implant 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.

SPP

The fertilized ovum (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 implanted. This increases the chances that pregnancy will still occur. Nevertheless, there is a great risk that you will have to repeat this procedure several times. It happens that the embryo does not take root even with the second, but with the fourth or fifth attempt. The abbreviation of the DPP indicates how many days passed after embryo introduction. This date is very important to make sure that the pregnancy has come, you need to wait for 14 DPP. HCG, the level of which is measured precisely at this time, is the main marker of this event.

HGH Hormone

Human chorionic gonadotropin (hCG) is normally defined only in the body of a pregnant woman. To develop it begins an egg, but, since it enters the body of a woman already fertilized, the appearance of this hormone in the analysis of blood or in urine means that the embryo has been successfully introduced. It is believed that the pregnancy occurred if the hCG at 14 DPI five-days (embryos that were introduced on the fifth day after the fertilization occurred) is not less than 100 mIU / l. If the indicators are 25 mIU / L and lower, then most likely the procedure will have to be repeated. However, low values of this analysis can be and in the event that time after embryo introduction has passed insufficiently, for example, define hCG at 12 DPP.

What does HCG show?

Chorionic gonadotropin is also called a pregnancy hormone. Immediately after fertilization, it prevents the yellow body from regressing and stimulating the synthesis of hormones such as estrogen and progesterone. In the serum, HCG is determined immediately after the oocyte has penetrated the uterine lining. 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 for 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 limits of the norm often become a marker of serious pathologies both in the mother's body and in the development of the fetus.

Methods for the determination of chorionic gonadotropin

In most women, after successful IVF, changes in the level of hCG begin to be monitored already on the 9th -14th day. In order to reveal its appearance, it is not even necessary to donate blood. Tests for pregnancy work on the principle of determining its presence in the urine. Of course, they do not indicate the exact figures and the amount of HCG on the DPP of five-day or three-day periods, but its very presence with a high probability indicates the onset of pregnancy. To obtain a more accurate result, the woman gives blood. If during normal pregnancy the blood for hormones is surrendered at the screening, which is carried out in the first trimester, then when performing in vitro fertilization for a more informative picture, gynecologists are advised to do this every 2-3 days after embryo introduction. The results obtained are compared with a table showing the minimum, maximum and average values of hCG at a certain time period.

The norms of hCG

Like all indicators, the level of hCG can vary within certain limits. Most often, the table shows the data of fluctuations in his level for weeks of pregnancy. There are also tables showing the increase in the level of the hormone hCG by days. They are most relevant for those who have IVF. In the table below, only the averages of the day after implantation (DPP) for embryos that were implanted 3 and 5 days after fertilization are indicated.

As can be seen, hCG at 7 DPP five-day periods is 45 mIU / L, but its normal values can range from 17 to 65 mIU / l. On the same day, the average for a three-day embryo will be 18, and the norm limits will be 8-26 mIU / L.

The reasons for the increase in hCG

As already mentioned, hCG is not only an indicator that pregnancy has occurred, but also allows you to monitor its course. In the event that the level of this hormone does not go far beyond the normal range, then this is not given much importance, but if the HGP indicators of DPP do not correspond significantly, this can signal a serious pathology of both the mother and the fetus. A significant increase in this indicator can result in:

• Chromosomal abnormalities in fetal development (Down syndrome);
• Trophoblastic tumors;
• Endocrine disorders (diabetes mellitus);
• Taking medications containing gestagens;
• Multiple pregnancies.

Causes of reduced hCG

A low level of charyotic gonadotropin can be registered in the following cases:

• Threatening abortion;
• Frozen pregnancy;
• Malformations of the fetus;
• Antenatal fetal death ;
• Pregnancy overstretch;
• Placental insufficiency;
• ectopic pregnancy.

Increased hCG on DPP. Twins

With IVF, in order to increase a woman's chances of becoming pregnant, she immediately implants two embryos, but this often does not guarantee the success of the procedure. However, there are also precedents, when both take root at once. In this case, hCG can grow by 2-3 times. This is due to the fact that it is produced not by one placenta, as it happens in single-pregnancy, but two at once. For example, if the level of hCG at 16 DPP five-day periods is an average of 1960 mIU / l, then for a twin, the normal rate will be 3920 mIU / L and higher.

The hCG in the diagnosis of fetal development 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 life that has arisen, there is a risk of pathology. The modern level of medicine allows many of them to diagnose and even correct in the early stages. This is why obligatory screenings are carried out in the first and second trimester of pregnancy. Screening for the first trimester, which usually takes 10-14 weeks, includes ultrasound and hormone control of hCG and RARP-A. Screening for the second trimester is carried out at 16-18 weeks. In it, along with ultrasound, a triple test (hCG, AFP, estriol) is carried out. The data of the second screening allow to determine the presence of pathologies with a high probability. In the event that against a background of low AFP and estriol levels, the level of hCG significantly exceeds the norm, with a high degree of probability it is possible to suspect the presence of a Down syndrome in the fetus. Syndromes of Edwards or Patau can be suspected at a low level of all three markers. Relatively normal values of chorionic gonadotropin at low AFP and estriol may indicate Turner syndrome.

All the predictions are made based on the individual characteristics of the ongoing pregnancy - the age of the mother, her weight, the presence of bad habits, concomitant pathologies, diseases in children born in previous pregnancies. If the survey revealed even minor deviations from the norm, a woman is obligatorily sent to a genetics consultation.

How to take the test

For the analysis on hCG it is required to hand over blood from the vein. Do it better in the morning and strictly on an empty stomach. In the event that you have to take it in the daytime, you need to refrain from eating for at least 6 hours. In the event that you are taking any medications that contain hormones ("Pregnil", "Horagon"), you should warn the doctor in advance.

In order for the laboratory study to be more informative, it is better to do it not earlier than 3-5 days after the delay in menstruation. In the case of IVF, the most accurate data will be diagnosed on day 14 after the procedure.