Document Detail

Hyperglycosylated human chorionic gonadotropin and the source of pregnancy failures.
MedLine Citation:
PMID:  17675003     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the proportion of hyperglycosylated human chorionic gonadotropin (hCG-H) produced at the time of implantation as a predictor of pregnancy success. DESIGN: Measuring daily urine hCG and hCG-H on the day of implantation. The time of implantation was assumed to be the first day of hCG detection (total hCG >1 mIU/mL). SETTING: Urine samples were collected at volunteers' homes throughout city of Albuquerque. PATIENT(S): 110 women attempting to conceive spontaneously; 62 achieved pregnancies (42 to term and 20 failed). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Measurements of the total hCG and hCG-H, and calculations of the proportion of hCG-H. RESULT(S): In all 42 term pregnancies, the proportion of hCG-H on the day of implantation was >50%. This was also true for 7 of the 20 failures. Statistically significant lower proportions of hCG-H (<50%) were observed in 13 of 20 pregnancies that eventually failed. The predictive values of proportion of hCG-H, concentration of hCG-H, total hCG, and regular hCG alone for detecting failures were 100%, 59%, 41%, and 21%, respectively. CONCLUSION(S): Hyperglycosylated is produced by cytotrophoblast cells in early pregnancy at the time of implantation. Effective proportions of hCG-H (>50%) are required for successful growth and invasion by cytotrophoblasts at the time of implantation. Low proportions of hCG-H at implantation predict failure and are likely to be the root of many pregnancy failures. The 7 of 20 failures with normal proportions of hCG-H were likely due to genetic, immune, or maternal causes. Measurement of a proportion of hCG-H <50% on the day of implantation absolutely indicates a failing pregnancy.
Yasushi Sasaki; Donald G Ladner; Laurence A Cole
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Publication Detail:
Type:  Journal Article     Date:  2007-08-06
Journal Detail:
Title:  Fertility and sterility     Volume:  89     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-03     Completed Date:  2008-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1781-6     Citation Subset:  IM    
USA hCG Reference Service, Division of Women's Health Research, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico 87131, USA.
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MeSH Terms
Abortion, Spontaneous / epidemiology*
Chorionic Gonadotropin / metabolism,  urine*
Embryo Implantation
New Mexico / epidemiology
Pregnancy Outcome*
Pregnancy Trimester, First
Pregnancy Trimester, Second
Stillbirth / epidemiology
Trophoblasts / physiology
Reg. No./Substance:
0/Chorionic Gonadotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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