Pregnancy: Prognostic models for the probability of achieving an ongoing pregnancy after in-vitro fertilization and the importance of testing their predictive value

Abstract

The aim of this study was to create reliable models to predict the probability of achieving an ongoing pregnancy during in-vitro fertilization (IVF) treatment: model A, at the start of the first treatment, model B at the time of embryo transfer, and model C, during the second treatment at the end of the first IVF treatment. Prognostic models were created using data from the University Hospital Nijmegen (n = 757) and applied to the data from the Catharina Hospital Eindhoven (n = 432), The Netherlands, to test their predictive performance. The predictions of model B (made at time of embryo transfer) were fairly good (c = 0.672 in the test population). For instance, 93% of the patients who had a predicted probability of achieving an ongoing pregnancy of < 10% did not achieve an ongoing pregnancy. However, the predictions of the other two models (A and C) for Eindhoven were less reliable. The predictive value of model C was fairly high in Nijmegen (c = 0.673). Its poor performance in the test population may be explained partly by differences in effectiveness of the ovulation stimulation protocols and the decision about when to discontinue the cycle. Thus, before using prognostic models at an IVF centre, their reliability at that specific centre should be tested.

Pre-hCG variables associated with occurrence of ascites in IVF/ICSI patients at moderate risk of developing OHSS: A pilot investigation

“…In the latter case, our model indicates that appropriate preventive strategies should be taken. In this context, it should be noted that prediction models often overestimate the predictive capacity when assessed in the same cohort in whom they have been developed [40,41]. Thus, an external validation of the present nomogram is needed to define its applicability in detecting patients at risk of developing moderate or severe OHSS.…”

Does the duration of gonadotropin stımulation affect embryo quality on post-retrieval day 3?

“…Stolwijk et al [29] developed a model of pregnancy after implantation and included the number and quality of the embryos in the model. They suggested that the probability of implantation was greatly increased in the presence of at least one good embryo and by higher numbers of embryos.…”

Intrauterine Insemination in Unexplained Female Infertility

“…Prognostic factors related to a higher cumulative pregnancy rate are duration of infertility less than 2 years, a previous pregnancy with the same partner and female age < 30 years. In these instances, couples could be encouraged to use less invasive treatments for up to 2-3 years because they have a similar chance of achieving pregnancy without treatment [32,33]. ART (IVF or ICSI) is indicated as first treatment option when the duration of UI is at least 3 years.…”