Obstetrics & Gynecology · 1 h ago
IVF cohort identifies potential ultrasound threshold for miscarriage diagnosis
A retrospective study of 10,009 IVF pregnancies found that an empty gestational sac at or beyond 47 days’ gestation had 100% positive predictive value for first-trimester miscarriage. The proposed threshold requires independent validation before clinical adoption.
- Cohort included 10,009 IVF pregnancies across 14 English centers.
- Early ultrasound measurements varied substantially even among viable pregnancies.
- Empty sacs at 47 days or later predicted miscarriage in-cohort.
- Independent validation is needed before adopting the proposed diagnostic threshold.
A retrospective multicenter cohort study in Ultrasound in Obstetrics & Gynecology examined early ultrasound findings in 10,009 IVF pregnancies from 14 centers in England. Most data covered 2022–2024, with one center also contributing 2019–2021 data. Pregnancies had a confirmed intrauterine pregnancy on initial transvaginal ultrasound by 9 weeks and 6 days; gestational age was calculated using embryo-transfer information. The endpoint was viability at the 11–14-week dating scan.
Overall, 8,223 pregnancies (82.2%) were viable and 1,786 (17.8%) were non-viable. Viable pregnancies had higher median crown–rump length (CRL) at the same gestational age, but measurements overlapped between outcome groups. CRL and mean sac diameter also varied substantially among viable pregnancies. Estimated mean CRL growth was 0.926 mm/day from the point when CRL was first measurable.
An empty gestational sac at or beyond 47 days’ gestation (n = 406) had a positive predictive value of 100% and specificity of 100% (95% CI, 94.9–100%) for first-trimester miscarriage. This finding suggests a potential diagnostic threshold in precisely dated IVF pregnancies, not an established practice standard. The retrospective design and physiological variation in ultrasound measurements warrant caution. The authors call for external validation in independent cohorts; the endpoint was first-trimester viability rather than live birth.
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Ultrasound in Obstetrics & Gynecology: Growth trajectory and miscarriage diagnosis threshold in early IVF pregnancy: multicenter study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.