Human chorionic gonadotropin serum levels following ovulation triggering and IVF cycle outcome

  • Yossi Mizrachi
  • Eran Horowitz
  • Jacob Farhi
  • David Levran
  • Arieh Raziel
  • Ariel Weissman
Assisted Reproduction Technologies



The clinical significance of serum hCG levels after ovulation triggering was studied previously with conflicting results. Our aim was to study the correlation of hCG levels on the day after ovulation triggering using recombinant hCG (r-hCG) with treatment outcome.


A prospective observational study of all fresh IVF/ICSI cycles in a single medical center, between January 2015 and June 2016, was performed. hCG serum levels were obtained 10–12 h following ovulation triggering with 250 mcg r-hCG. Clinical and laboratory outcome parameters were compared between cycles with serum hCG above and below median level. A multivariate regression analysis was performed in order to study the association between hCG levels and live birth rate, after controlling for confounders.


Overall, 326 cycles were included. Median serum hCG level was 91.35 IU/L. hCG levels were lower as age and BMI were higher (p = 0.004, p < 0.001, respectively). The study groups did not differ with regard to clinical pregnancy rate (p = 0.14), live birth rate (p = 0.09), fertilization rate (p = 0.45), or metaphase II oocyte rate (p = 0.68). On multivariate regression analysis, hCG level was not associated with live birth (aOR 0.99, 95% CI 0.98–1.005), after controlling for patient’s age and BMI.


hCG levels on the day after ovulation triggering with 250 mcg r-hCG are inversely correlated with patient age and BMI. However, they are not correlated with any clinical or laboratory outcome parameter. Therefore, testing for hCG levels after ovulation induction seems futile and cannot be recommended.


Human chorionic gonadotropin IVF BMI Outcome 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was not requested by our LRB, because during the study period it was our standard policy to monitor hCG serum level in the morning after ovulation triggering.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.IVF Unit, Department of Obstetrics and GynecologyThe Edith Wolfson Medical CenterHolonIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel-AvivIsrael

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