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

Abstract

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. 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 ,40 years, whereas age was a better predictor for women ≥40 years. The restricted cubic spline analysis revealed the relationship between the total number of good-quality embryos and log-odds of achieving a clinical pregnancy was nonlinear.conclusions: Quality and quantity of the whole embryos are the two most important predictors of the cumulative outcome in IVF/ ICSI among independent predictors indentified. The importance of embryo quality on cumulative outcome in IVF/ICSI increases with increasing age.

Quality of embryos transferred and progesterone levels are the most important predictors of live birth after fresh embryo transfer: a retrospective cohort study

“…Some have focused on factors predicting pregnancy after fresh embryo transfer [1], whereas others have focused on predicting the cumulative outcome of a completed IVF cycle, which includes a fresh cycle and/or subsequent frozen cycles [2]. Very few previous works have examined whether predictors of cumulative outcome still retain their predictive value in a fresh cycle or vice versa.…”

“…Cai et al found that the size and quality of the embryo cohort are the strongest predictors of cumulative outcome in a completed treatment cycle [2]. Jun et al concluded that embryo cohort-specific variables are more informative than any measures of individual transferred embryos in a fresh cycle [3].…”

“…In view of these issues, the present work utilized data from a large cohort of patients [2] to identify the independent predictors of live birth in a fresh IVF cycle. Specifically, the study intended to clarify the role of cohort-specific parameters including AFC, the number of oocytes retrieved, the total number of embryos, and the total number of good-quality embryos, in pregnancy prognosis after fresh embryo transfer, and to verify the status of potential predictors still under debate.…”

Platelet-rich plasma therapy and reproductive medicine

“…Results from studies on the role of endometrial thickness on implantation and live births are contradictory. While some authors reported that there is not a relationship [16,17], there is one retrospective study that shows that there is a steady and gradual increase in pregnancy rates as endometrial thickness increases [18]. Furthermore, the last authors claimed that this relationship exists independent of maternal age and embryo quality.…”

Demographic characteristics and AMH levels in rural and urban women participating in an IVF programme

“…The most important factors are maternal age and Antimüllerian hormone (AMH) level [1,2]. The number and quality of the embryos available for transfer also play an essential role [1,3,4]. Different models predicting IVF success rate have been proposed, taking into account clinical and embryological data [5][6][7].…”