Porcu, Géraldine
Lehert, Philippe
[UCL]
Colella, Carolina
Giorgetti, Claude
Background: Women having experienced several consecutive failing IVF cycles constitute a critical and particular subset of patients, for which growing perception of irremediable failure, increasing costs and IVF treatment related risks necessitate appropriate decision making when starting or not a new cycle. Predicting chances of LB might constitute a useful tool for discussion between the patient and the clinician. Our essential objective was to dispose of a simple and accurate prediction model for use in routine medical practice. The currently available predictive models applicable to general populations cannot be considered as accurate enough for this purpose.Methods: Patients with at least four consecutive Failing cycles (CFCs) were selected. We constructed a predictive model of LB occurrence during the last cycle, by using a stepwise logistic regression, using all the baseline patient characteristics and intermediate stage variables during the four first cycles.Results: On as set of 151 patients, we identified five determinant predictors: the number of previous cycles with at least one gestational sac (NGS), the mean number of good-quality embryos, age, male infertility (MI) aetiology and basal FSH. Our model was characterized by a much higher discrimination as the existing models (C-statistics=0.76), and an excellent calibration.Conclusions: Couples having experienced multiple IVF failures need precise and appropriate information to decide to resume or interrupt their fertility project. Our essential objective was to dispose of a simple and accurate prediction model to allow a routine practice use. Our model is adapted to this purpose: It is very simple, combines five easily collected variables in a short calculation; it is more accurate than existing models, with a fair discrimination and a well calibrated prediction. © 2013 Porcu et al.; licensee BioMed Central Ltd.
- Habbema J.D.F., Towards less confusing terminology in reproductive medicine: a proposal, 10.1093/humrep/deh303
- Lintsen A.M.E., Braat D.D.M., Habbema J.D.F., Kremer J.A.M., Eijkemans M.J.C., Can differences in IVF success rates between centres be explained by patient characteristics and sample size?, 10.1093/humrep/dep358
- Leushuis Esther, van der Steeg Jan Willem, Steures Pieternel, Bossuyt Patrick M.M., Eijkemans Marinus J.C., van der Veen Fulco, Mol Ben W.J., Hompes Peter G.A., Prediction models in reproductive medicine: a critical appraisal†, 10.1093/humupd/dmp013
- Templeton Allan, Morris Joan K, Parslow William, Factors that affect outcome of in-vitro fertilisation treatment, 10.1016/s0140-6736(96)05291-9
- Hunault Claudine C, Eijkemans Marinus J.C, Pieters Math H.E.C, te Velde Egbert R, Habbema J.Dik F, Fauser Bart C.J.M, Macklon Nicholas S, A prediction model for selecting patients undergoing in vitro fertilization for elective single embryo transfer, 10.1016/s0015-0282(01)03243-5
- Steures Pieternel, van der Steeg Jan Willem, Mol Ben W.J, Eijkemans Marinus J.C, van der Veen Fulco, Habbema J.Dik F, Hompes Peter G.A, Bossuyt Patrick M.M, Verhoeve Harold R, van Kasteren Yvonne M, van Dop Peter A, Prediction of an ongoing pregnancy after intrauterine insemination, 10.1016/j.fertnstert.2003.12.028
- Smeenk J.M.J., External validation of the Templeton model for predicting success after IVF, 10.1093/humrep/15.5.1065
- van Loendersloot L.L., van Wely M., Repping S., van der Veen F., Bossuyt P.M.M., Templeton prediction model underestimates IVF success in an external validation, 10.1016/j.rbmo.2011.02.012
- Steyerberg Ewout W, Harrell Frank E, Borsboom Gerard J.J.M, Eijkemans M.J.C, Vergouwe Yvonne, Habbema J.Dik F, Internal validation of predictive models, 10.1016/s0895-4356(01)00341-9
- Nelson Scott M., Lawlor Debbie A., Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation: A Prospective Study of 144,018 Treatment Cycles, 10.1371/journal.pmed.1000386
- Ferraretti A. P., La Marca A., Fauser B. C. J. M., Tarlatzis B., Nargund G., Gianaroli L., , ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria, 10.1093/humrep/der092
- Leridon H., Can assisted reproduction technology compensate for the natural decline in fertility with age? A model assessment, 10.1093/humrep/deh304
- Pullium Jennifer K, Milner Ross, Tuma Gary A, Pregnancy following homologous prepubertal ovarian transplantation in the dog, 10.1186/1743-1050-5-1
- Cooke S., Meiotic spindle location and identification and its effect on embryonic cleavage plane and early development, 10.1093/humrep/deg447
- Swets J., Measuring the accuracy of diagnostic systems, 10.1126/science.3287615
- Cai Q. F., Wan F., Huang R., Zhang H. W., Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients, 10.1093/humrep/der228
- Malizia Beth A., Hacker Michele R., Penzias Alan S., Cumulative Live-Birth Rates after In Vitro Fertilization, 10.1056/nejmoa0803072
| Bibliographic reference |
Porcu, Géraldine ; Lehert, Philippe ; Colella, Carolina ; Giorgetti, Claude. Predicting live birth chances for women with multiple consecutive failing IVF cycles: A simple and accurate prediction for routine medical practice. In: Reproductive Biology and Endocrinology, Vol. 11, no. 1 (2013) |
| Permanent URL |
http://hdl.handle.net/2078.1/160802 |
