Pregnancy prediction models and eSET criteria for IVF patients–do we need more information?

Ottosen, Lars Ditlev Mørck; Kesmodel, Ulrik Schiøler; Hindkjær, Johnny; Ingerslev, Hans Jakob

doi:10.1007/s10815-006-9082-9

Cited by 51 publications

(54 citation statements)

References 47 publications

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“…23 In this study it is observed that effect of ovarian aging on FORT is negligible as compared to PFC, basal E2 and FSH levels and antral follicles continue to respond to FSH irrespective of ovarian aging which is supported by other studies. 11,24 The present study reflected that high peak E2 (at the time of OI) is associated with greater number of oocytes maturity, retrieval, fertilization, cleavage and the number of top quality embryos which enhance chances of clinical pregnancy as observed in other studies 14,25 The suggested high peak E2 for improvement of oocyte and embryo quality was observed in high FORT group of our study, similar results were shown in another study. 26,27 The increased E2 produced by growing follicles in the window of implantation, increases endometrial receptivity by apposition, attachment and apposition for the encroaching blastocyst.…”

Section: Discussionsupporting

confidence: 90%

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Rehman

Mustafa

Hoor

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Background: We aimed to estimate pregnancy outcome after ICSI in terms of oocyte parameters, embryo quality, endometrial thickness, hormone and cytokine levels in women stratified on the basis of follicular output rate (FORT). Methods: Quasi experimental design was carried out after approval from "Ethical review board of Islamabad clinic serving infertile couples" from July 2010 to August 2013. One thousand and fifty females were selected with the criteria of age between 21-40 years, infertility of more than 2 years, body mass index of 18-35 kg/m 2 , menstrual cycle of 25 ± 7 days, both ovaries present with normal uterine cavity, serum FSH levels less than 8 IU/ml and normal thyroid-stimulating hormone levels. Females on short agonist or antagonist protocol with diagnosis of polycystic ovarian syndrome, fibroids or in their male partner sperms retrieved by testicular biopsy were excluded from the study. Down regulation of ovaries was followed by controlled ovarian stimulation, Ovulation Induction (OI), oocyte pick up, in vitro fertilization, Embryo Transfer (ET) and confirmation of pregnancy was done by serum beta hCG of more than 25 mIU/ml and cardiac activity on trans vaginal scan. Enzyme linked immuno sorbent assay was used for peak and mid luteal estradiol (E2), progesterone (P) and interleukin I-β estimation on OI and ET days respectively. FORT (ratio of preovulatory follicle count to antral follicle count × 100 on OI day) stratified females into low under the 33 rd percentile, medium between the 33 rd and the 67 th percentile and high above the 67 th percentile. Characteristics of groups were compared by one way analysis of variance. Results: Females 276 (33%), 288 (34%) and 282 (33%) comprised of low, medium and high FORT groups respectively. The number of retrieved, mature and fertilized oocytes, cleaved embryos, endometrial thickness and number of gestational sacs in the high FORT group was significantly high (P <0.001). High peak and midluteal E2 (P = 0.0025, 0.0001), low P (P = 0.0001) and high peak interleukin-1β (P = 0.0001) was observed in high FORT in comparison with medium FORT with resultant greater number of clinical pregnancies 183 (65%). Conclusions: The FORT in non PCOS patients may reflect good reproductive outcome after ICSI with maximum clinical pregnancies in high FORT group.

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Section: Discussionsupporting

confidence: 90%

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Rehman

Mustafa

Hoor

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…Two embryonic variables, the total number of good-quality embryos and total number of embryos, ranked as the most important and second most important predictors of clinical pregnancy chance after a completed IVF/ICSI cycle (Table III). Most previous studies focused on the quality and number of transferred embryos because they aimed at the outcome of fresh cycles (Terriou et al, 2001;Hunault et al, 2002;Lee et al, 2006;Ottosen et al, 2007). We used the total number of good-quality embryos and total number of embryos to assess the quality and quantity of all the embryos from one ovarian stimulated cycle in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Although in vitro fertilization (IVF) has become a commonly used ART since the first birth after IVF-embryo transfer on 25 July 1978, the IVF process still remains a difficult one for the infertile couples with low success rates on the first attempt. Furthermore, the high twin pregnancy rate arising from IVF has been recognized as a significant public health issue leading, in many countries, to policies encouraging or mandating increased use of single-embryo transfer (SET) (Hunault et al, 2002;Ledger et al, 2006;Ottosen et al, 2007;Roberts et al, 2009). These factors have led to a need to study further predictors and to evaluate the probability of a patient achieving a pregnancy as accurately as possible before and during the course of her IVF treatment.…”

Section: Introductionmentioning

confidence: 99%

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

Cai

Wan

Huang³

et al. 2011

Human Reproduction

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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.

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“…çalışmalarında hem bazal FSH'nın hem de yaş faktörünün IVF performansında etkili olduğunu belirtmişlerdir (18) . Yapılan diğer çalışmalarda bazal FSH'sı 0-10 IU/1 ve 10 IU/1'den yüksek olan hastalar iki grupta değerlendirilmiş ve bazal FSH'sı 0-10 IU/1 olan kadınlarda gebelik şansının daha yüksek olduğu bildirilmiştir (19,20) . Bizim çalışmamızda, gebe (7,9±2,1) ve gebe olmayan (8,3±4,0) grupların bazal FSH değerleri karşılaştırıldığında bu değerin gebelik oluşumunu istatistiksel olarak anlamlı etkilemediği görülmüştür.…”

Section: Discussionunclassified

The effects of prognostic factors on pregnancy success among women 39 years or older having intracytoplasmic sperm injection

Doğan¹,

Kovalı²,

Doğan³

et al. 2014

tjod

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Amaç: Bu çalışmada 39 yaş ve üzeri infertil kadın hastalarda yaşın, prognostik faktörler ile üreme potansiyeli üzerindeki sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: İleri yaşta (≥39 yıl) 107 infertil kadın hasta retrospektif olarak değerlendirildi. Hastaların insan koryonik gonadotropin (hCG) uygulanan günde ölçülen endometrium kalınlığı, toplam kullanılan gonadotropin dozu, stimülasyon süreleri, 3. gün bazal follikül stimüle edici hormon (FSH) ile bazal estradiol (E 2 ) düzeyleri, toplanan oosit ile fertilize oosit sayıları ve transfer edilen embriyo sayıları kaydedildi. Bu parametrelerin gebelik başarısı üzerine etkileri değerlendirildi. Hastalar 39 yaş (n=47), 40-41 yaş (n=37) ve 42 ve üzeri yaş (n=23) olmak üzere üç yaş grubu karşılaştırıldı. Bulgular: Canlı doğum oranı 39 yaş grubunda %23,2 ve 40-41 yaş grubunda %14,7 olarak gözlendi. Kırk iki ve üzeri yaş grubunda ise canlı doğum görülmedi. Bu çalışmanın sonuçları yaşın, toplanan oosit ve fertilize oosit sayısının gebelik gelişimi üzerine etkisinin olduğunu gösterdi. Sonuç: Gebelik oranı 39 yaşından sonra hızlı bir şekilde düşmektedir; intrasitoplazmik sperm enjeksiyonu sonrası, hastalarda 39 yaşından itibaren gebelik başarısı 3 yıl sonra 9 kat azalmıştır. İleri maternal yaşın, gebelik ve canlı doğum oranları üzerindeki olumsuz etkisi klinik çalışmamızda da gözlenmiştir. J Turk Soc Obstet Gynecol 2014;2:78-83 Anahtar Kelimeler: Kadın, yaş, gebelik oranı Objective: The objective of this study is to investigate the effect of age on the prognostic factors and fertilization potential of infertile women who are 39 years or older. Material and Methods: 107 patients with advanced maternal age (≥39 years) were included in this retrospective study. The endometrial thickness on the day of human chorionic gonadotropin (hCG), total dose of gonadotropin used, duration of stimulation, levels of day-3 basal follicule stimulating hormone (FSH) and basal estradiol (E 2 ), number of retrieved oocytes and fertilized oocytes, and number of embryos transferred were recorded. These parameters were used to evaluate their effects on the success of pregnancy. Patients were categorized into three age groups: 39 years old (n=47), 40-41 years old (n=37), and ≥ 42 years old (n=23) and age groups were compared. Results: The rate of live birth was %23.2 in 39 years and %14.7 in 40-41 years. No live birth in 42 years or older patients was recorded. The results revealed that that the age, number of retrieved oocytes and fertilized oocytes predict the success rate of pregnancy. Conclusion: Pregnancy rate dramatically decreased after the age of 39; the success of pregnancy after the intracytoplasmic sperm injection decreases 9 times, three years later starting age of 39. The negative effect of advanced maternal age on pregnancy and live birth rates was observed in our clinical study, as well. J Turk Soc Obstet Gynecol 2014;2:78-83

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Pregnancy prediction models and eSET criteria for IVF patients–do we need more information?

Cited by 51 publications

References 47 publications

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

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

The effects of prognostic factors on pregnancy success among women 39 years or older having intracytoplasmic sperm injection

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