A prediction model for live birth and multiple births within the first three cycles of assisted reproductive technology

Models of the probability of live birth and multiple births are a function of age, BMI, gravidity, prior full-term births, infertility diagnosis, number of embryos transferred, and cycle number.

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Authors

Barbara Luke, Sc.D., M.P.H., Morton B. Brown, Ph.D., Ethan Wantman, M.B.A., Judy E. Stern, Ph.D., Valerie L. Baker, M.D., Eric Widra, M.D., Charles C. Coddington, III, M.D., William E. Gibbons, M.D., G. David Ball, Ph.D.

Volume 102, Issue 3, Pages 744-752

Abstract

Objective:

To develop a model predictive of live-birth rates (LBR) and multiple birth rates (MBR) for an individual considering assisted reproduction technology (ART) using linked cycles from Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) for 2004–2011.

Design:

Longitudinal cohort.

Setting:

Clinic-based data.

Patient(s):

288,161 women with an initial autologous cycle, of whom 89,855 did not become pregnant and had a second autologous cycle and 39,334 did not become pregnant in the first and second cycles and had a third autologous cycle, with an additional 33,598 women who had a cycle using donor oocytes (first donor cycle).

Intervention(s):

None.

Main Outcome Measure(s):

LBRs and MBRs modeled by woman’s age, body mass index, gravidity, prior full-term births, infertility diagnoses by oocyte source, fresh embryos transferred, and cycle, using backward-stepping logistic regression with results presented as adjusted odds ratios (AORs) and 95% confidence intervals.

Result(s):

The LBRs increased in all models with prior full-term births, number of embryos transferred; in autologous cycles also with gravidity, diagnoses of male factor, and ovulation disorders; and in donor cycles also with the diagnosis of diminished ovarian reserve. The MBR increased in all models with number of embryos transferred and in donor cycles also with prior full-term births. For both autologous and donor cycles, transferring two versus one embryo greatly increased the probability of a multiple birth (AOR 27.25 and 38.90, respectively).

Conclusion(s):

This validated predictive model will be implemented on the Society for Assisted Reproductive Technology Web site (www.sart.org) so that patients considering initiating a course of ART can input their data on the Web site to generate their expected outcomes.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00469-5/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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