What this card shows
The hCG positive test rate per transfer (thawed oocytes) card shows what share of embryo transfers produced a positive hCG test, month by month. hCG is the pregnancy hormone, so a positive hCG test is the first sign that a transfer has taken.
This card covers one of the three cryopreservation paths a transfer can take: the thawed oocytes path, where the oocytes (eggs) were frozen at an earlier point, then thawed, fertilized and transferred in this cycle. Two companion cards cover the other two paths, transfers in cycles where nothing was frozen and transfers in cycles that used thawed embryos. The three sit one under the other on the same dashboard tab so you can read them together.
Each point sits on the month the transfer took place. The card plots three series:
hCG positive test rate (%), the solid line, read against the left axis.
Transfers (count), the pink dashed line, read against the right axis. This is the number of transfers the rate is calculated from.
Transfers awaiting a pregnancy test result (count), the purple dashed line, also read against the right axis.
Reading the card
Every point is a share of transfers, not of cycles or of patients. A cycle with two transfers contributes two.
Read the counts before you read the line. This is the smallest of the three cryopreservation paths in most services, often only a handful of transfers a month, and at that size a rate moves a long way on one extra pregnancy. Compare several months together rather than month against month, and treat a month with very few transfers as no signal at all.
The awaiting-result line is the one to watch on recent months. A transfer counts toward the rate as soon as it happens, but its pregnancy test result is usually recorded some weeks later. Until that result is entered, the transfer sits in the denominator without ever counting as positive, so it pulls the rate down. It tells you how many transfers in each month are in that state. When it sits close to the transfers line, the rate for that month is not yet meaningful.
That line also picks up results that were never entered at all, not just results that have not arrived yet. If it stays high on months that are six months old, that is a records gap rather than a reporting delay, and it is worth chasing.
Both the pregnancy test result and the freeze and thaw history are read for the cycle as a whole rather than for each transfer separately. If a cycle included more than one transfer, all of its transfers are grouped on the same card, and a positive test recorded anywhere in that cycle counts for each of them. Cycles with more than one transfer are uncommon, so this rarely moves the line, but it is worth knowing if you are looking at a patient you recognize.
The card lives on the Medical director dashboard, on the Clinical success tab, and responds to the filters at the top:
Date: change the time window. It scopes by the date of the transfer, and defaults to the past 6 months plus the current month.
Clinic: focus on one or more locations, if your organization has several.
Age at cycle start and BMI: narrow to a patient group. Bear in mind that narrowing the cohort makes the monthly numbers smaller still, and the line correspondingly noisier.
Where this data comes from
Two different parts of the record feed this card, and both need to be filled in for a transfer to appear in the right place.
The pregnancy test result comes from the Outcomes tab of the patient's Cycle page. Use the Add Outcome menu there and choose the blood or urine hCG test.
That opens the lab report form, where the hCG value and the pregnancy test result are entered. The card reads the pregnancy test result, so a report saved with a hormone value but no result selected still counts as awaiting a result, and is included in the awaiting-result line.
Which of the three cards a transfer lands on comes from what the lab recorded on the Culture tab of the same Cycle page. This is where oocyte thaws, fertilization, and embryo freezing and thawing are all logged.
A transfer appears on this card only when an oocyte thaw is recorded against its cycle and no embryo thaw is. If the oocyte thaw is not recorded, the transfer is counted as never frozen instead, on the first of the three cards. If this card looks emptier than the work your lab actually does, the Culture tab entries are the first place to look.
Opening this card
In wawa, open Insights from the sidebar, then go to Standard Reports → Medical Director → Medical director. Select the Clinical success tab. The hCG positive test rate per transfer (thawed oocytes) card is on it.