Abstract
Purpose
To introduce a prognostic model for women’s assisted fecundity before starting the first IVF/ICSI treatment cycle.
Methods
In contrast to previous predictive models, we analyze two groups of women at the extremes of prognosis. Specifically, 708 infertile women that had either a live birth (LB) event in the first autologous IVF/ICSI cycle (“high-assisted-fecundity women”, n = 458) or did not succeed in having a LB event after completing three autologous IVF/ICSI cycles (“low-assisted-fecundity women”, n = 250). The initial sample of 708 women was split into two sets in order to develop (n = 531) and internally validate (n = 177) a predictive logistic regression model using a forward-stepwise variable selection.
Results
Seven out of 32 initially selected potential predictors were included into the model: women’s age, presence of multiple female infertility factors, number of antral follicles, women’s tobacco smoking, occurrence of irregular menstrual cycles, and basal levels of prolactin and LH. The value of the c-statistic was 0.718 (asymptotic 95% CI 0.672–0.763) in the development set and 0.649 (asymptotic 95% CI: 0.560–0.738) in the validation set. The model adequately fitted the data with no significant over or underestimation of predictor effects.
Conclusion
Women’s assisted fecundity may be predicted using a relatively small number of predictors. This approach may complement the traditional procedure of estimating cumulative and cycle-specific probabilities of LB across multiple complete IVF/ICSI cycles. In addition, it provides an easy-to-apply methodology for fertility clinics to develop and actualize their own predictive models.
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Change history
23 December 2019
The original article unfortunately contained a mistake. In Table 2, the headers “Development set” and “Validation set” were not aligned to to their sub-headers.
23 December 2019
The original article unfortunately contained a mistake. In Table 2, the headers ���Development set��� and ���Validation set��� were not aligned to to their sub-headers.
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This study was approved by the Ethical Committee of Clinical Investigation, Valencia University Clinical Hospital, on November 30 2017 (2017/316).
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The original version fo this article was revised: In Table 2, the headers "Development set" and "Validation set" were not aligned to its sub-header.
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Tarín, J.J., Pascual, E., García-Pérez, M.A. et al. A predictive model for women’s assisted fecundity before starting the first IVF/ICSI treatment cycle. J Assist Reprod Genet 37, 171–180 (2020). https://doi.org/10.1007/s10815-019-01642-3
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DOI: https://doi.org/10.1007/s10815-019-01642-3