Large blastocyst diameter, early blastulation, and low preovulatory serum progesterone are dominant predictors of clinical pregnancy in fresh autologous cycles.
OBJECTIVE
To identify dominant predictors of clinical pregnancy in IVF cycles.


METHODS
Retrospective study.


METHODS
Private fertility center.


METHODS
The study included 580 fresh autologous IVF cycles with blastocyst transfer.


METHODS
None.


METHODS
Clinical pregnancy rate.


RESULTS
A set of 25 suspected predictors was used to develop predictive models of clinical pregnancy in a set of 361 blastocyst transfer cycles. Initial bivariate analysis identified 14 of these variables that were significant enough to be candidate variables for multiple logistic regression. Similar sets of significant variables were identified by using alternative approaches for model construction. The final model included blastocyst diameter, day of blastulation, and preovulatory serum P level as significant predictors of clinical pregnancy. Specifically, clinical pregnancy was predicted by preovulatory serum P of <1.0 ng/mL, blastulation on day 5, and large blastocyst diameter. Of these variables, blastocyst diameter was the most significant predictor of clinical pregnancy in the multivariate models. The final model was validated against a separate set of 219 subsequent blastocyst transfer cycles.


CONCLUSIONS
Pre-ovulatory serum P level, blastulation day, and embryo diameter are simultaneously predictive of clinical pregnancy, and their relationships with clinical pregnancy are consistent with an effect of embryo-endometrium synchrony.
Shapiro
Bruce S
BS
Fertility Center of Las Vegas, Las Vegas, Nevada 89117, USA. bsshapiro@aol.com
Daneshmand
Said T
ST
Garner
Forest C
FC
Aguirre
Martha
M
Thomas
Shyni
S
D000328:Adult; D001755:Blastocyst / Q000166:cytology* / Q000502:physiology; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008954:Models, Biological; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies
D011374:Progesterone