Prediction of an ongoing pregnancy after intrauterine insemination.
OBJECTIVE
To develop a prognostic model for the outcome of IUI.


METHODS
Retrospective cohort study.


METHODS
Four fertility centers in The Netherlands.


METHODS
Couples of whom the female partners had a regular cycle and who had been treated with IUI.


METHODS
Intrauterine insemination with and without ovarian hyperstimulation.


METHODS
Ongoing pregnancy.


RESULTS
Overall, 3371 couples were included who underwent 14968 cycles. There were 1229 (8.2%) pregnancies, of which 1000 (6.7%) pregnancies were ongoing. Logistic regression analysis demonstrated that increasing maternal age, longer duration of subfertility, presence of male factor subfertility, one-sided tubal pathology, endometriosis, uterine anomalies, and an increasing number of cycles were unfavorable predictors for an ongoing pregnancy. Cervical factor and the use of ovarian hyperstimulation were favorable predictors. The area under the receiver operating characteristic curve was 0.59. When couples were divided into four categories based on prognosis, the difference between the predicted and observed chance, that is, the calibration, was less than 0.5% in each of the four groups.


CONCLUSIONS
Although our model had a relatively poor discriminative capacity, data on calibration showed that the selected prognostic factors allow distinction between couples with a poor prognosis and couples with a good prognosis. After external validation, this model could be of use in patient counseling and clinical decision making.
Steures
Pieternel
P
Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. pn.steures@amc.uva.nl
van der Steeg
Jan Willem
JW
Mol
Ben W J
BW
Eijkemans
Marinus J C
MJ
van der Veen
Fulco
F
Habbema
J Dik F
JD
Hompes
Peter G A
PG
Bossuyt
Patrick M M
PM
Verhoeve
Harold R
HR
van Kasteren
Yvonne M
YM
van Dop
Peter A
PA
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000628:therapy*; D007315:Insemination, Artificial; D016015:Logistic Models; D008297:Male; D008954:Models, Biological; D015999:Multivariate Analysis; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies