Predicting personalized multiple birth risks after in vitro fertilization-double embryo transfer.
OBJECTIVE
To report and evaluate the performance and utility of an approach to predicting IVF-double embryo transfer (DET) multiple birth risks that is evidence-based, clinic-specific, and considers each patient's clinical profile.


METHODS
Retrospective prediction modeling.


METHODS
An outpatient university-affiliated IVF clinic.


METHODS
We used boosted tree methods to analyze 2,413 independent IVF-DET treatment cycles that resulted in live births. The IVF cycles were retrieved from a database that comprised more than 33,000 IVF cycles.


METHODS
None.


METHODS
The performance of this prediction model, MBP-BIVF, was validated by an independent data set, to evaluate predictive power, discrimination, dynamic range, and reclassification.


RESULTS
Multiple birth probabilities ranging from 11.8% to 54.8% were predicted by the model and were significantly different from control predictions in more than half of the patients. The prediction model showed an improvement of 146% in predictive power and 16.0% in discrimination over control. The population standard error was 1.8%.


CONCLUSIONS
We showed that IVF patients have inherently different risks of multiple birth, even when DET is specified, and this risk can be predicted before ET. The use of clinic-specific prediction models provides an evidence-based and personalized method to counsel patients.
Boston IVF, Waltham, Massachusetts, USA.
Benjamin M
BM
Lannon
Bokyung
B
Choi
Michele R
MR
Hacker
Laura E
LE
Dodge
Beth A
BA
Malizia
C Brent
CB
Barrett
Wing H
WH
Wong
Mylene W M
MW
Yao
Alan S
AS
Penzias
D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000379:methods; D005544:Forecasting / Q000379:methods; D006801:Humans; D007206:Individuality; D007246:Infertility / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D015233:Models, Statistical; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome