Abstract
Live birth is the most important concern for assisted reproductive technology (ART) patients. Therefore, in the medical reproductive centre, obstetricians often need to answer the following question: “What are the chances that I will have a healthy baby after ART treatment?” To date, our obstetricians have no reference on which to base the answer to this question. Our research aimed to solve this problem by establishing prediction models of live birth for ART patients. Between January 1, 2010, and May 1, 2017, we conducted a retrospective cohort study of women undergoing ART treatment at the Reproductive Medicine Centre, Xiangya Hospital of Central South University, Hunan, China. The birth of at least one live-born baby per initiated cycle or embryo transfer procedure was defined as a live birth, and all other pregnancy outcomes were classified as no live birth. A live birth prediction model was established by stepwise multivariate logistic regression. All eligible subjects were randomly allocated to two groups: group 1 (80% of subjects) for the establishment of the prediction models and group 2 (20% of subjects) for the validation of the established prediction models. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each prediction model at different cut-off values were calculated. The prediction model of live birth included nine variables. The area under the ROC curve was 0.743 in the validation group. The sensitivity, specificity, PPV, and NPV of the established model ranged from 97.9–24.8%, 7.2–96.3%, 44.8–83.8% and 81.7–62.5%, respectively, at different cut-off values. A stable, reliable, convenient, and satisfactory prediction model for live birth by ART patients was established and validated, and this model could be a useful tool for obstetricians to predict the live rate of ART patients. Meanwhile, it is also a reference for obstetricians to create good conditions for infertility patients in preparation for pregnancy.
Highlights
Live birth is the most important concern for assisted reproductive technology (ART) patients
Based on our univariate analysis results, we found that maternal age, body mass index, number of previous ART treatments, female infertility duration, number of previous pregnancies, number of abortions, basal FSH, sperm concentration, endometrial thickness before embryo transfer, number of antral follicles, total number of oocytes, sperm viability, sperm progressive motility, type of embryo transfer, quality of transferred embryos, maternal education, infertility diagnosis, uterine volume, artificial insemination technology used, stimulation protocol, total number of transferred embryos, and total dose of gonadotropin were significantly associated with live birth
Our model is a convenient and practical prediction model because information on all the variables included in the model is generally available in the clinic, and there is no need for any special test
Summary
Live birth is the most important concern for assisted reproductive technology (ART) patients. A stable, reliable, convenient, and satisfactory prediction model for live birth by ART patients was established and validated, and this model could be a useful tool for obstetricians to predict the live rate of ART patients. It is a reference for obstetricians to create good conditions for infertility patients in preparation for pregnancy. Live birth is the most important concern for assisted reproductive technology (ART) patients; it is the only criterion used to determine whether ART treatment is successful. The main reasons may include the following: (1) they cannot be applied to all ART patients because the model is based on only 1–2 types of ART patients; (2) some predictors need more complicated and expensive laboratory tests; (3) the use of these models is not sufficiently convenient, and (4) some models are less accurate than others for predicting live birth
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