Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients

BACKGROUND Knowing predictors of pregnancy in IVF is helpful for clinicians to individualize the treatment plans and improve patient counseling and for patients to decide whether to undergo infertility treatment. The aim of the study was to identify independent predictors of the chance of clinical p...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2011-09, Vol.26 (9), p.2532-2540
Main Authors: Cai, Q.F., Wan, F., Huang, R., Zhang, H.W.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Embryo Transfer
Female
Gynecology. Andrology. Obstetrics
Humans
Infertility, Female - therapy
Medical sciences
Multivariate Analysis
Predictive Value of Tests
Pregnancy
Pregnancy Rate
Retrospective Studies
Treatment Outcome
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Summary:BACKGROUND Knowing predictors of pregnancy in IVF is helpful for clinicians to individualize the treatment plans and improve patient counseling and for patients to decide whether to undergo infertility treatment. The aim of the study was to identify independent predictors of the chance of clinical pregnancy after a completed IVF/ICSI cycle (fresh plus cryopreserved embryos transferred from one stimulated cycle) and to compare the predictive value of important predictors identified. METHODS This was a single center, retrospective study of 2450 infertile women undergoing their first IVF treatment between 2002 and 2007. A bootstrapping stepwise variable selection algorithm was performed to identify independent predictors of clinical pregnancy chance from a list of 27 candidate variables. Multivariable logistic regression was used for assessing the effects of predictors. Proportion of explained variation analysis and concordance index were adopted to compare the predictive value of factors. RESULTS The following nine independent predictors were included in the final multivariable model: total number of good-quality embryos, total number of embryos, age, antral follicle count, fertilization rate, duration of infertility, endometrial thickness, number of 10–14-mm follicles and progesterone level on the day of hCG injection. The model was cross-validated internally in the training data and validated externally in an independent data with robust performance. The stratified analysis demonstrated that the total number of good-quality embryos was a better predictor of clinical pregnancy chance after a completed IVF/ICSI cycle than age for women
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/der228