title: Prediction of an ongoing pregnancy after intrauterine insemination.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. pn.steures@amc.uva.nl
authors.forename: Pieternel
authors.initials: P
authors.lastname: Steures
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: van der Steeg
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.forename: Marinus J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
authors.forename: J Dik F
authors.initials: JD
authors.lastname: Habbema
authors.forename: Peter G A
authors.initials: PG
authors.lastname: Hompes
authors.forename: Patrick M M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Harold R
authors.initials: HR
authors.lastname: Verhoeve
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: van Kasteren
authors.forename: Peter A
authors.initials: PA
authors.lastname: van Dop
mesh_terms: 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