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.
Verberg
Marieke F G
MFG
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands. Electronic address: m.f.g.verberg@umcutrecht.nl.
Eijkemans
Marinus J C
MJC
Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Macklon
Nicholas S
NS
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Heijnen
Esther M E W
EMEW
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Fauser
Bart C J M
BCJM
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
Broekmans
Frank J
FJ
Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands.
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