Abstract
Background: In developed countries, the prevalence of infertility ranges from 3.5% to 16.7%. Therefore, the number of in vitro fertilization technique (IVF) and its subtype intracytoplasmic sperm injection (ICSI) treatments has been significantly increasing across Europe. Several factors affect the success rate of in vitro treatments, which can be used to calculate the probability of success for each couple. As these treatments are complicated and expensive with a variable probability of success, the most common question asked by IVF patients is ‘‘What are my chances of conceiving?”. The main aim of this study is to develop a validated model that estimates the chance of a live birth before they start their IVF non-donor cycle. Methods: A logistic regression model was developed based on the retrospective study of 737 IVF cycles. Each couple was characterized by 14 variables (woman’s and man’s age, duration of infertility, cause of infertility, woman’s and man’s body mass index (BMI), anti-Müllerian hormone (AMH), antral follicle count (AFC), woman’s and man’s ethnicity, woman’s and man’s smoking status and woman’s and man’s previous live children) and described with the outcome of the treatment "Live birth" or "No live birth". Results: The model results showed that from the 14 variables acquired before starting the IVF procedures, only male factor, man’s BMI, man's mixed ethnicity and level of AMH were statistically significant. The interactions between infertility duration and woman’s age, infertility duration and man’s BMI, AFC and AMH, AFC and woman’s age, AFC and woman’s BMI and AFC and disovulation were also statistically significant. The area under the receiver operating characteristic (AUROC) curve test for the discriminatory ability of the final prediction model is 0.700 (95% confidence interval (CI) 0.660–0.741). Conclusions: This model might result in a new validated decision support system to help physicians to manage couples’ expectations.
Highlights
Infertility is defined as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse[1]
The present work is a retrospective study of data from in vitro fertilization technique (IVF)/ intracytoplasmic sperm injection (ICSI) cycles
The same was seen for men and women with lower body mass index (BMI) and shorter infertility durations
Summary
Infertility is defined as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse[1] Taking this definition into account, it is a challenge to calculate the real prevalence or incidence rates for this condition[2]. According to the study performed by Boivin et al.[3], the prevalence of infertility ranged from 3.5% to 16.7% in developed countries. Results: The model results showed that from the 14 variables acquired before starting the IVF procedures, only male factor, man’s BMI, man's mixed ethnicity and level of AMH were statistically significant. The area under the receiver operating characteristic (AUROC) curve test for the discriminatory ability of the final prediction model is 0.700 (95% confidence interval (CI) 0.660–0.741)
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