title: Patient-specific predictions of outcome after gonadotropin ovulation induction/intrauterine insemination.
abstract: OBJECTIVE
  To use patient-specific and cycle-specific characteristics to predict clinical pregnancy, multiple pregnancy, and spontaneous abortion rates after gonadotropin ovulation induction (OI)/IUI.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Academic fertility center.
  
  
  METHODS
  A total of 1,438 women who underwent 3,375 gonadotropin OI/IUI cycles.
  
  
  METHODS
  Individual and cycle-specific characteristics were evaluated to determine predictors of the rates of clinical pregnancy, multiple pregnancy, and spontaneous abortion. Logistic regression using individual parameters was used to create predictive models.
  
  
  METHODS
  Clinical pregnancy (CPR), multiple pregnancy (MPR), and spontaneous abortion rates (SABR).
  
  
  RESULTS
  Multiple predictors were identified for CPR, MPR, and SABR. The presence of at least two follicles ≥ 13 mm at ovulation trigger significantly increased CPR (odds ratio [OR], 95% confidence interval [CI] = 1.45, 1.18-1.78) and MPR (OR, 95% CI = 5.17, 2.16-12.41). An E2 level >400 pg/mL significantly increased MPR (OR, 95% CI = 9.54, 2.31-39.42). Logistic regression models were developed for individualized predictions of outcome.
  
  
  CONCLUSIONS
  Regression analysis reveals the patient and cycle-specific characteristics that are significant predictors of CPR, MPR, and SABR after OI/IUI. Logistic models using significant or nearly significant predictors for CPR, MPR, and SABR offer improved predictive power relative to simpler models, and allow for the development of a risk calculator for personalized patient counseling.
authors.affiliation: Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts. Electronic address: rhgoldman@partners.org.
authors.forename: Randi H
authors.initials: RH
authors.lastname: Goldman
authors.affiliation: Reproductive Endocrinology and Infertility Division, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Maria
authors.initials: M
authors.lastname: Batsis
authors.affiliation: Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts; Reproductive Endocrinology and Infertility Division, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: John C
authors.initials: JC
authors.lastname: Petrozza
authors.affiliation: Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts; Reproductive Endocrinology and Infertility Division, Massachusetts General Hospital Fertility Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Irene
authors.initials: I
authors.lastname: Souter
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000046:Academic Medical Centers; D000328:Adult; D003661:Decision Support Techniques; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005640:Follicle Stimulating Hormone; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007315:Insemination, Artificial / Q000009:adverse effects; D016015:Logistic Models; D008596:Menotropins / Q000008:administration & dosage; D016017:Odds Ratio; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000009:adverse effects; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D008596:Menotropins; D005640:Follicle Stimulating Hormone
keywords: Ovulation induction; clinical pregnancy rate; intrauterine insemination; multiple pregnancy; predictive models