Multivariate Markov chain analysis of the probability of pregnancy in infertile couples undergoing assisted reproduction.
BACKGROUND
Estimating the probability of pregnancy leading to delivery and the influence of clinical factors on that probability is of fundamental importance in the treatment counselling of infertile couples. A variety of statistical techniques have been used to analyse fertility data, many borrowed from survival analysis.


RESULTS
We propose an alternative method of analysis which is based on a discrete time Markov chain approach, with states 'pregnancy (leading to a delivery)', 'not pregnant', and 'censored' and in which the transition probabilities are dependent both on the clinical characteristics of the patient and the treatment given.


CONCLUSIONS
We believe that the method of analysis presented here may be preferable to standard analyses in that it better reflects the clinical situation, it is a truly discrete time analysis applied to a discrete time situation, it explicitly models the censoring process (a process which in itself provides information of interest to the physician) and can be readily extended to a variety of clinical situations.
McDonnell
Joseph
J
Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands. mcdonnell@bmg.eur.nl
Goverde
Angelique J
AJ
Rutten
Frans F H
FF
Vermeiden
Jan P W
JP
D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008297:Male; D008390:Markov Chains; D011247:Pregnancy; D012044:Regression Analysis; D012099:Reproductive Techniques; D016896:Treatment Outcome