Abstract
PurposeSeveral mathematical models have been developed to estimate individualized chances of assisted reproduction techniques (ART) success, although with limited clinical application. Our study aimed to develop a decisional algorithm able to predict pregnancy and live birth rates after controlled ovarian stimulation (COS) phase, helping the physician to decide whether to perform oocytes pick-up continuing the ongoing ART path.MethodsA single-center retrospective analysis of real-world data was carried out including all fresh ART cycles performed in 1998–2020. Baseline characteristics, ART parameters and biochemical/clinical pregnancies and live birth rates were collected. A seven-steps systematic approach for model development, combining linear regression analyses and decision trees (DT), was applied for biochemical, clinical pregnancy, and live birth rates.ResultsOf fresh ART cycles, 12,275 were included. Linear regression analyses highlighted a relationship between number of ovarian follicles > 17 mm detected at ultrasound before pick-up (OF17), embryos number and fertilization rate, and biochemical and clinical pregnancy rates (p < 0.001), but not live birth rate. DT were created for biochemical pregnancy (statistical power–SP:80.8%), clinical pregnancy (SP:85.4%), and live birth (SP:87.2%). Thresholds for OF17 entered in all DT, while sperm motility entered the biochemical pregnancy’s model, and female age entered the clinical pregnancy and live birth DT. In case of OF17 < 3, the chance of conceiving was < 6% for all DT.ConclusionA systematic approach allows to identify OF17, female age, and sperm motility as pre-retrieval predictors of ART outcome, possibly reducing the socio-economic burden of ART failure, allowing the clinician to perform or not the oocytes pick-up.
Highlights
Infertility, defined as the inability to achieve clinical pregnancy after 1 year of regular unprotected sexual intercourses, is estimated to affect between 8 and 16% of reproductive-aged couples worldwide [1]
We previously demonstrated rates were significantly higher in couples in which the man showed sperm motility higher than 34% compared to the others only in in vitro fertilization (IVF) cycles
OF17 number, female age, and sperm motility could be used to evaluate whether the assisted reproduction techniques (ART) path should be continued before pick-up
Summary
Infertility, defined as the inability to achieve clinical pregnancy after 1 year of regular unprotected sexual intercourses, is estimated to affect between 8 and 16% of reproductive-aged couples worldwide [1]. Journal of Assisted Reproduction and Genetics of psychological, social, and economic health [5,6,7] In this context, mathematical models are generated predict strong outcomes, such as pregnancy and live birth rates. Mathematical models are generated predict strong outcomes, such as pregnancy and live birth rates On these parameters, several predictive models for ART have been developed over the last three decades in order to estimate individualized chances of treatment success [8]. Several predictive models for ART have been developed over the last three decades in order to estimate individualized chances of treatment success [8] These models are required to select either the ART approach applicable to the couple or the best treatment for the female partner [9]. Scientific societies suggest to tailor COS schemes on the female characteristics [10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
