Multivariate analysis of factors predictive of successful live births in in vitro fertilization (IVF) suggests strategies to improve IVF outcome.
OBJECTIVE
Our purpose was (1) to identify characteristics correlated with pregnancy outcome, (2) to use these characteristics to predict in vitro fertilization (IVF) outcome, and (3) to develop strategies that might improve IVF success.


METHODS
Maternal age, cause for IVF, donor insemination, rank of attempt, serum estradiol and luteinizing hormone levels on the day of human chorionic gonadotropin administration, flexible vs rigid catheter, number of embryos transferred of each morphologic type, and cell number were analyzed by logistic regression.


RESULTS
Variables positively correlated with success are as follows: (1) for pregnancy, endometriosis and 2-, 3-, and 4-cell good and 4-cell excellent embryos; (2) for live births, 2-, 3-, and 4-cell good and 4-cell excellent embryos and donor insemination; and (3) for multiple births, 2- and 4-cell good and 4-cell excellent embryos. Maternal age was negatively correlated with live births.


CONCLUSIONS
Embryos derived from IVF have different potentials for implantation, live births, and multiple births. Transferring one additional good-quality embryo for each 5 years of incremental increase in maternal age is predicated to improve live birth rates without increasing multiple births.
Department of Obstetrics and Gynecology and Reproductive Biology, Beth Israel Hospital, Harvard Medical School, Boston, USA.
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D
Minaretzis
D
D
Harris
M M
MM
Alper
J F
JF
Mortola
M J
MJ
Berger
D
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Power
D000328:Adult; D000704:Analysis of Variance; D004624:Embryo Transfer / Q000592:standards* / Q000706:statistics & numerical data; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D007248:Infertility, Male / Q000473:pathology*; D016013:Likelihood Functions; D016015:Logistic Models; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008423:Maternal Age; D015999:Multivariate Analysis; D009865:Oocytes / Q000502:physiology; D006080:Ovarian Follicle / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000502:physiology / Q000706:statistics & numerical data; D011336:Probability; D013084:Sperm-Ovum Interactions / Q000502:physiology; D013094:Spermatozoa / Q000502:physiology; D016896:Treatment Outcome
D004958:Estradiol; D007986:Luteinizing Hormone