Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis.
BACKGROUND
Various models have been developed for the prediction of pregnancy after in vitro fertilization (IVF). These models differ from one another in the predictors they include. We performed a systematic review and meta-analysis to identify the most relevant predictors for success in IVF.


METHODS
We systematically searched MEDLINE and EMBASE for studies evaluating IVF/ICSI outcome. Studies were included if they reported an unconditional odds ratio (OR) or whenever one could be calculated for one or more of the following factors: age, type of infertility, indication, duration of infertility, basal FSH, number of oocytes, fertilization method, number of embryos transferred and embryo quality.


RESULTS
Fourteen studies were identified. A summary OR could be calculated for five factors. We found negative associations between pregnancy and female age [OR: 0.95, 95% confidence interval (CI): 0.94-0.96], duration of subfertility (OR: 0.99, 95% CI: 0.98-1.00) and basal FSH (OR: 0.94, 95% CI: 0.88-1.00). We found a positive association with number of oocytes (OR 1.04, 95% CI: 1.02-1.07). Better embryo quality was associated with higher pregnancy chances. No significant association was found for the type of infertility and fertilization method. A summary OR for IVF indication and number of embryos transferred could not be calculated, because studies reporting on these used different reference categories.


CONCLUSIONS
Female age, duration of subfertility, bFSH and number of oocytes, all reflecting ovarian function, are predictors of pregnancy after IVF. Better quality studies are necessary, especially studies that focus on embryo factors that are predictive of success in IVF.
van Loendersloot
L L
LL
Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Meibergdreef 9, Amsterdam, The Netherlands. l.l.vanloendersloot@amc.uva.nl
van Wely
M
M
Limpens
J
J
Bossuyt
P M M
PM
Repping
S
S
van der Veen
F
F
D000328:Adult; D000367:Age Factors; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008875:Middle Aged; D009865:Oocytes / Q000166:cytology / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome
D005640:Follicle Stimulating Hormone