Predictors of ongoing pregnancy after single-embryo transfer following mild ovarian stimulation for IVF.
OBJECTIVE
To develop a prognostic model for the prediction of ongoing pregnancy after single-embryo transfer (SET) following mild stimulation for IVF in women less than 38 years of age.


METHODS
Prospective cohort study.


METHODS
Two fertility centers in tertiary referral university hospitals.


METHODS
A total of 152 women with an elective SET following mild ovarian stimulation (cycle day 5 start of 150 IU/day recombinant FSH and late follicular phase GnRH antagonist cotreatment).


METHODS
Database analysis.


METHODS
Ongoing pregnancy.


RESULTS
The ongoing pregnancy rate per elective SET was 28% (42 of 152). In a multivariate logistic regression analysis, body mass index, the total gonadotrophin dose needed, and number of oocytes retrieved were negatively correlated whereas the availability of a top-quality embryo was positively correlated with ongoing pregnancy. The predictive ability of the model assessed by the area under the receiver operating characteristic curve was 0.68. At a probability cut-off level of 0.20 the model showed a sensitivity of 37% and a specificity of 90%.


CONCLUSIONS
The developed prediction model for ongoing pregnancy provides an evidence-based strategy for guidance under which conditions SET may be performed. After external validation, application of the model may help to improve overall singleton pregnancy rates.
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands. Electronic address: m.f.g.verberg@umcutrecht.nl.
Marieke F G
MFG
Verberg
Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Marinus J C
MJC
Eijkemans
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Nicholas S
NS
Macklon
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Esther M E W
EMEW
Heijnen
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Bart C J M
BCJM
Fauser
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Frank J
FJ
Broekmans
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D015331:Cohort Studies; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity
D006063:Chorionic Gonadotropin; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone; C061018:ganirelix