Predictors of treatment failure in young patients undergoing in vitro fertilization.

Abstract

The purpose of the study was to evaluate whether routinely collected clinical factors can predict in vitro fertilization (IVF) failure among young, "good prognosis" patients predominantly with secondary infertility who are less than 35years of age. Using de-identified clinic records, 414 women <35years undergoing their first autologous IVF cycle were identified. Logistic regression was used to identify patient-driven clinical factors routinely collected during fertility treatment that could be used to model predicted probability of cycle failure. One hundred ninety-seven patients with both primary and secondary infertility had a failed IVF cycle, and 217 with secondary infertility had a successful live birth. None of the women with primary infertility had a successful live birth. The significant predictors for IVF cycle failure among young patients were fewer previous live births, history of biochemical pregnancies or spontaneous abortions, lower baseline antral follicle count, higher total gonadotropin dose, unknown infertility diagnosis, and lack of at least one fair to good quality embryo. The full model showed good predictive value (c = 0.885) for estimating risk of cycle failure; at ≥80% predicted probability of failure, sensitivity = 55.4%, specificity = 97.5%, positive predictive value = 95.4%, and negative predictive value = 69.8%. If this predictive model is validated in future studies, it could be beneficial for predicting IVF failure in good prognosis women under the age of 35years.