Pregnancy And Newborn by Petr Kratochvil

Here's some interesting info for those with not quite doubling HCG numbers:

When evaluating the patient who presents with increasing levels of HCG, clinical decisions are facilitated by the well-defined curve of expected hCG rise.

This curve, first described by Kadar et al, recently has been redefined.

A 53% increase in HCG concentration in 2 days, rather than a 66% increase, is now considered the lower limit of normal and defines a viable intrauterine pregnancy (K.T. Barnhart et al, in press).

A slower rate of increase from this expectation suggests a nonviable pregnancy and prompts intervention to distinguish an ectopic pregnancy from miscarriage

Full Abstract

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TODAY'S BOOK SUGGESTION:

Ready: Why Women Are Embracing The New Later Motherhood
by Elizabeth Gregory

-- Over the past three decades, skyrocketing numbers of women have chosen to start their families in their late thirties and early forties.

In 2005, ten times as many women had their first child between the ages of 35 and 39 as in 1975, and thirteen times as many had their first between 40 and 44.

Women now have the option to define for themselves when they're ready for family, rather than sticking to a schedule set by social convention.

As a society, however, we have yet to come to terms with the phenomenon of later motherhood, and women who decide it makes sense for them to delay pregnancy often find themselves confronted with alarmist warnings about the dangers of waiting too long.

In Ready, Elizabeth Gregory tracks the burgeoning trend of new later motherhood and demonstrates that for many women today, waiting for family works best.

She provides compelling evidence of the benefits of having children later -- by birth or by adoption.

Paperback: 336 pages
Click to order/for more info: Ready - US | CDN | UK

Start reading Ready on your Kindle in under a minute!

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Case 1: A repeat ultrasound 6 days after the initial one revealed no change: a persistent empty gestational sac without a fetal pole.

The evidence pointed to an inevitable abortion [miscarriage]; however, the patient's stable condition and the clinician's skepticism about the available information prompted further waiting.

Two days later, the [beta]-HCG level was 29,000, and a third ultrasound 13 days after the original one demonstrated a viable intrauterine pregnancy corresponding to a fetal age of 8 weeks.

The patient subsequently gave birth to a normal male infant at term.

Case 2: At 7 2/7 weeks a pelvic ultrasound examination was obtained. It indicated a gestational sac of 22 mm mean diameter, which corresponded to an age of 7 weeks.

No fetal pole was visualized, however, and the possibility of a blighted ovum or an incomplete abortion [miscarriage] was raised. One week later the physical examination was unchanged.

The patient's [beta]-HCG level that day (8 2/7 weeks) was 123,000 mIU/mL; 48 hours later the level was 50,840 mIU/mL. The patient was informed of the significance of the results and advised to repeat the tests in 1 week.

The following week the patient's [beta]-HCG level was 710,000 mIU/mL, and a second ultrasound examination 2 1/2 weeks after the initial study demonstrated a viable 9 1/2-week fetus.

The patient gave birth to a normal female infant at 42 weeks.

Photo credit: Baby And Dad Sleeping 
by Vera Kratochvil

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TODAY'S BOOK SUGGESTION:
Green Fertility: Nature's Secrets For Making Babies: A Powerful Proven Plan To Help You Get Pregnant Fast and Have a Healthy Baby
by Niels H. Lauersen and Colette Bouchez
-- Renowned fertility expert Dr. Niels Lauersen and women's natural wellness expert Colette Bouchez combine the best of nature's secrets with all that Eastern and Western medicine have to offer, in an easy, inexpensive plan to help you get pregnant fast and have super healthy babies!

Based on scientific research and tested on thousands of couples, this unique natural approach to conception is designed to uncover what's keeping you from getting pregnant and help you maximize your fertility and have healthier babies - even if you have PCOS, Endometriosis or you are diagnosed with unexplained infertility!

Paperback: 502 pages
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FIRST RESPONSE Early Results Pregnancy Test now has patent pending technology that can detect the pregnancy hormone, human chorionic gonadotropin (hCG), up to six days before the day of a woman’s missed period with unsurpassed accuracy -- one day before any other at-home pregnancy test available on the market.

“A pregnancy test with results this early sets the stage for a healthy baby and a healthy mother. This latest advancement means pregnant women can initiate a healthier lifestyle even sooner in the critical first stages of a baby’s development,” said Mary Jane Minkin*, MD, board-certified obstetrician/gynecologist in private practice in New Haven, Connecticut, and a Clinical Professor of Obstetrics and Gynecology at Yale University School of Medicine. “Women who want results quickly will undoubtedly have less anxiety when taking this at-home test.”

FIRST RESPONSE pregnancy kits work by detecting the presence of the pregnancy hormone (hCG) in a woman’s urine. HCG begins to appear in a pregnant woman 8-10 days after fertilization. The amount of hCG doubles every 36-48 hours as the pregnancy progresses. And now with patent pending Polymeric Amplification Technology (PAT) that only FIRST RESPONSE has, FIRST RESPONSE can detect the pregnancy hormone at lower levels than ever before.

Source



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Human chorionic gonadotropin administration is associated with high pregnancy rates during ovarian stimulation and timed intercourse or intrauterine insemination

Background
There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods
Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and 1363 intrauterine insemination cycles). Stimulation protocols included clomiphene alone or with FSH injection, letrozole (an aromatase inhibitor) alone or with FSH, and FSH alone. LH-surge was defined as an increase in LH level ≥200% over mean of preceding two days. When given, hCG was administered at a dose of 10,000 IU. The main outcome was clinical pregnancy rate per cycle.

Results
Higher pregnancy rates occurred in cycles in which hCG was given. Occurrence of an LH-surge was associated with a higher pregnancy rate with clomiphene treatment, but a lower pregnancy rate with FSH treatment.

Conclusions
hCG administration is associated with a favorable outcome during ovarian stimulation. Awaiting occurrence of LH-surge is associated with a better outcome with CC but not with FSH treatment.

Full study: http://www.rbej.com/content/2/1/55

Photo by nubuck
Found this on FertilityFriend today:

Photo by www.cbsnews.com
(CBS) "Is it possible that I'm pregnant?" can be one of the most nerve-wracking questions for a woman to deal with. But with so many pregnancy tests on the market today, how can you tell which is relaiable?

Consumer Reports senior editor Nancy Metcalf talks about the best pregnancy tests available. Get the recommendations on Tuesday’s The Early Show.

Method:
All home pregnancy test kits use monoclonal antibodies to detect a hormone known as human chorionic gonadotropin (hCG), which is produced by the developing placenta beginning on the day on which the embryo implants in the uterine wall. Concentrations of this pregnancy hormone vary widely from woman to woman, but the more sensitive tests can measure lower levels of hCG.

All 18 brands tested by "Consumer Reports" (CR) employ similar technology - most use sticks with absorbent wicks that are held directly in the urine stream, and most allow women to collect urine in a cup and then dip the stick. Regardless of collection method, reading the results is the same for every kit: if a line appears in the window after a specified number of minutes, the test is positive.

Working with an independent laboratory that specializes in hCG studies, CR spiked hCG-free urine with varying concentrations of the hormone "to mimic the range found in normal early pregnancies."

They tested each product at increasing levels of hCG concentration until a positive result was attained.

"We conducted the tests as instructed on each product's package insert," CR says. "Technicians read the results after the specified minimum wait - anywhere from 1 to 5 minutes, depending on the product - and then again at the maximum time allowed (10 minutes in all the products we tested)." Kits were rated on efficacy, ease of use, and ease of result readings.

Performance:
One kit, the First Response Early Result Pregnancy Test, emerged as the most reliable and sensitive test. "It detected hCG at concentrations as low as 6.5 mIU/ml (thousandths of an International Unit per milliliter) - that's almost sensitive enough to detect any pregnancy soon after implantation," CR wrote. "Most other kits were far less sensitive - the five least sensitive tests couldn't detect hCG below concentrations of about 100 MIU/ml at their specified reading times. However, when we waited a full 10 minutes before reading the results, seven of the test kits performed much better than they did at the manufacturer's suggested waiting time."

Although all the kits were "easy to use," First Response and two other tests (Answer Quick & Simple and ClearBlue Easy) produced result lines that were more intense than others at lower concentrations of hCG, making them easiest to read.

In the end, First Response's Early Result Pregnancy test ($18.09/2 tests) came out on top, with an "Excellent" rating (winning an "excellent" score in hCG sensitivity, "good" in ease of reading, and "excellent" in 10-minute hCG sensitivity, with an overall recommendation of "best combination of sensitivity and reliability). Confirm's Pregnancy Test ($11.19/2 tests) scored lowest, with a final score of "Poor" ("fair," hCG sensitivity; "poor," ease of reading; and "fair," 10-minute hCG sensitivity, with some samples failing to work properly).

Ratings

First Response Early Result Pregnancy Test
($18.09 for two)
Consumer Reports Rating: Excellent

Confirm Pregnancy Test
($11.19 for two)
Consumer Reports Rating: Poor

Recommendations:
Although CR calls the First Response test "a superior choice," it warns, "Women need to use home pregnancy test kits with a clear understanding of their limitations."

It explains that testing for hCG is not the same in all women. In 10 percent of pregnant women, the embryo does not implant until after the first day of a missed period (and again, hCG is not produced until the embryo implants in the uterine wall).

"Until implantation, it doesn't matter how sensitive the test is," CR says, "You can't detect the pregnancy before it's producing the stuff that you're measuring, which is hCG."

Even pregnancies that have implanted may produce too little hCG for many at-home tests to detect, especially only a day or two after a missed period and when read after the manufacturer suggested waiting period specified in test packaging.

"Some kits improve in detection when read after a wait of 10 minutes, but waiting longer than that may produce a negative result that looks faintly, misleadingly positive," CR reports.

Moreover, about one-third to one-quarter of pregnancies implant for a short time, then fail. "That leads to a transient rise in hCG, which can extend for as long as two days after the day of the missed menstrual period."

Consumer Reports advises, "If you're comfortable waiting, a sensitive test taken a week after your period is overdue will almost certainly give you accurate results. If you elect to take the test as early as the day after you've missed your period, remember that a negative result isn't 100 percent certain. And a positive result may mean either a viable pregnancy or a pregnancy destined to end shortly after it began. With either of those results, you should plan on testing again a week later, just to be sure."

Source: http://www.cbsnews.com/stories/2003/01/27/earlyshow/health/main538075.shtml


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