Prediction of pregnancy in IVF cycles on the fourth day of ovarian stimulation

Abstract

Purpose Prediction of IVF outcome on the first days of ovarian stimulation has focused clinical research for many years. The aim of this work is to predict the probability of pregnancy on the fourth day of ovarian stimulation for IVF cycle, using parameters usually determined in this stageestradiol, antral follicle count-together with parameters determined previously: FSH on the third day of cycle and women age. Materials and methods One hundred and ten patients with primary infertility due to a tubal factor were recruited to participate in a prospective study. FSH was determined on the third day of spontaneous cycle. Antral follicles and estradiol were measured on the fourth day of ovarian stimulation. After oocyte pick-up, quality and quantity of oocytes and embryos and pregnancy rates were assessed. Results In stepwise multiple logistic regression the variables with better predictiveness over pregnancy are: antral follicles count, estradiol and woman age. The logistic regression analyses demonstrate that the capacity of the model that uses these variables to predict pregnancy is 75%, with a positive predictive value of 69% and a negative predictive value of 80%. Conclusions On the fourth day of ovarian stimulation of IVF cycles, the variables with highest predictiveness are: antral follicle count, estradiol and women age. When these variables are included in a model of prediction, the capacity to predict pregnancy is 75%.

Anti-Müllerian hormone-based prediction model for a live birth in assisted reproduction

“…The prediction of assisted reproduction treatment outcome has been the focus of clinical research for many years, with a variety of prognostic models describing the probability of an ongoing pregnancy or a live birth following treatment. To date, models have predominantly been established using patient baseline characteristics and although these models have been heterogeneous in their performance they consistently demonstrate that certain patient characteristics are associated with IVF/intracytoplasmic sperm injection (ICSI) success, including female age (Bancsi et al, 2000;Bouckaert et al, 1994;Carrera-Rotllan et al, 2007;Commenges-Ducos et al, 1998;Hughes et al, 1998;Hunault et al, 2002;Hull et al, 1996;Lee et al, 2009;Lintsen et al, 2005;Minaretzis et al, 1998;Ottosen et al, 2007;Stolwijk et al, 1996;Stolwijk et al, 2000;Templeton et al, 1996;van Weert et al, 2008;Younis et al, 2009), duration of infertility (Haan et al, 1991;Lintsen et al, 2007;Younis et al, 2009), pregnancy history (Lintsen et al, 2007;Stolwijk et al, 2000;Templeton et al, 1996;van Weert et al, 2008), diagnostic category (Bancsi et al, 2000;Lintsen et al, 2007;van Weert et al, 2008) and body mass index (BMI;Ferlitsch et al, 2004;Verberg et al, 2008).…”

“…Moreover it has been clearly demonstrated that in models predicting pregnancy based on intermediate results (at embryo transfer), the number of retrieved and fertilized oocytes have the highest prognostic value (Ferlitsch et al, 2004;Verberg et al, 2007). This suggests that any marker which can predict the number of retrieved oocytes prior to ovarian stimulation may be of value in initial baseline prognostic models (Bancsi et al, 2000;Carrera-Rotllan et al, 2007;Ferlitsch et al, 2004;Lee et al, 2009;Ottosen et al, 2007;Younis et al, 2009).…”

The antral follicle count: practical recommendations for better standardization

“…The correlation between the AFC and reproductive age is now well recognized (7,(10)(11)(12)(13)(14), and the prognostic value of the AFC in ART treatment is well established (3,8,13,(15)(16)(17)(18)(19)(20)(21). Early follicular-phase AFC also has a predictive value for ovarian response to ART that is better or at least equivalent to that of complex hormonal tests, such as the exogenous FSH ovarian reserve test and the clomiphene citrate challenge test (22).…”

The predictive value of antral follicle count remains unchanged across the menstrual cycle

“…The AFC has also been used as a predictor of ovarian reserve (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Recent studies have shown that AMH and the AFC are equally effective in predicting poor ovarian response in an IVF program (18,19,21).…”