A prediction model for live birth and multiple births within the first three cycles of assisted reproductive technology

• Published in: Fertility and sterility Vol. 102; no. 3; pp. 744 - 752
• Main Authors: Luke, Barbara, Sc.D., M.P.H, Brown, Morton B., Ph.D, Wantman, Ethan, M.B.A, Stern, Judy E., Ph.D, Baker, Valerie L., M.D, Widra, Eric, M.D, Coddington, Charles C., M.D, Gibbons, William E., M.D, Ball, G. David, Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014
• Subjects: Adolescent; Adult; Assisted reproductive technology; BMI; donor cycle; Female; Humans; Infant, Newborn; Infertility, Female - epidemiology; Infertility, Female - therapy; Internal Medicine; Live Birth - epidemiology; Longitudinal Studies; Male; Middle Aged; Models, Statistical; Multiple Birth Offspring - statistics & numerical data; Obstetrics and Gynecology; prediction model; Pregnancy; Pregnancy, Multiple - statistics & numerical data; Prognosis; Reproductive Techniques, Assisted - statistics & numerical data; Validation Studies as Topic; Young Adult; donor cycle; Assisted reproductive technology; prediction model; BMI
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2014.05.020

Objective To develop a model predictive of live-birth rates (LBR) and multiple birth rates (MBR) for an individual considering assisted reproduction technology (ART) using linked cycles from Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) for 2004–2011. Design Longitudinal cohort. Setting Clinic-based data. Patient(s) 288,161 women with an initial autologous cycle, of whom 89,855 did not become pregnant and had a second autologous cycle and 39,334 did not become pregnant in the first and second cycles and had a third autologous cycle, with an additional 33,598 women who had a cycle using donor oocytes (first donor cycle). Intervention(s) None. Main Outcome Measure(s) LBRs and MBRs modeled by woman's age, body mass index, gravidity, prior full-term births, infertility diagnoses by oocyte source, fresh embryos transferred, and cycle, using backward-stepping logistic regression with results presented as adjusted odds ratios (AORs) and 95% confidence intervals. Result(s) The LBRs increased in all models with prior full-term births, number of embryos transferred; in autologous cycles also with gravidity, diagnoses of male factor, and ovulation disorders; and in donor cycles also with the diagnosis of diminished ovarian reserve. The MBR increased in all models with number of embryos transferred and in donor cycles also with prior full-term births. For both autologous and donor cycles, transferring two versus one embryo greatly increased the probability of a multiple birth (AOR 27.25 and 38.90, respectively). Conclusion(s) This validated predictive model will be implemented on the Society for Assisted Reproductive Technology Web site ( www.sart.org ) so that patients considering initiating a course of ART can input their data on the Web site to generate their expected outcomes.