title: Application of a validated prediction model for in vitro fertilization: comparison of live birth rates and multiple birth rates with 1 embryo transferred over 2 cycles vs 2 embryos in 1 cycle.
abstract: OBJECTIVE
  The purpose of this study was to use a validated prediction model to examine whether single embryo transfer (SET) over 2 cycles results in live birth rates (LBR) comparable with 2 embryos transferred (DET) in 1 cycle and reduces the probability of a multiple birth (ie, multiple birth rate [MBR]).
  
  
  METHODS
  Prediction models of LBR and MBR for a woman considering assisted reproductive technology developed from linked cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System for 2006-2012 were used to compare SET over 2 cycles with DET in 1 cycle. The prediction model was based on a woman's age, body mass index (BMI), gravidity, previous full-term births, infertility diagnoses, embryo state, number of embryos transferred, and number of cycles.
  
  
  RESULTS
  To demonstrate the effect of the number of embryos transferred (1 or 2), the LBRs and MBRs were estimated for women with a single infertility diagnosis (male factor, ovulation disorders, diminished ovarian reserve, and unexplained); nulligravid; BMI of 20, 25, 30, and 35 kg/m2; and ages 25, 35, and 40 years old by cycle (first or second). The cumulative LBR over 2 cycles with SET was similar to or better than the LBR with DET in a single cycle (for example, for women with the diagnosis of ovulation disorders: 35 years old; BMI, 30 kg/m2; 54.4% vs 46.5%; and for women who are 40 years old: BMI, 30 kg/m(2); 31.3% vs 28.9%). The MBR with DET in 1 cycle was 32.8% for women 35 years old and 20.9% for women 40 years old; with SET, the cumulative MBR was 2.7% and 1.6%, respectively.
  
  
  CONCLUSIONS
  The application of this validated predictive model demonstrated that the cumulative LBR is as good as or better with SET over 2 cycles than with DET in 1 cycle, while greatly reducing the probability of a multiple birth.
authors: Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, MI. Electronic address: lukeb@msu.edu.
authors: Barbara
authors: B
authors: Luke
authors: Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.
authors: Morton B
authors: MB
authors: Brown
authors: Redshift Technologies, Inc., New York, New York.
authors: Ethan
authors: E
authors: Wantman
authors: Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH.
authors: Judy E
authors: JE
authors: Stern
authors: Department of Obstetrics and Gynecology, Stanford University, Palo Alto, CA.
authors: Valerie L
authors: VL
authors: Baker
authors: Shady Grove Fertility Center, Washington, DC.
authors: Eric
authors: E
authors: Widra
authors: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
authors: Charles C
authors: CC
authors: Coddington
authors: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.
authors: William E
authors: WE
authors: Gibbons
authors: Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA.
authors: Bradley J
authors: BJ
authors: Van Voorhis
authors: Seattle Reproductive Medicine, Seattle, WA.
authors: G David
authors: GD
authors: Ball
mesh_terms: D000328:Adult; D003661:Decision Support Techniques; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D050498:Live Birth / Q000453:epidemiology*; D016015:Logistic Models; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D056826:Single Embryo Transfer / Q000379:methods*
keywords: assisted reproductive technology; live birth; multiple birth; prediction model