Barbara Luke1, Morton B Brown2, Ethan Wantman3, Judy E Stern4, Valerie L Baker5, Eric Widra6, Charles C Coddington7, William E Gibbons8, G David Ball9. 1. Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan. Electronic address: lukeb@msu.edu. 2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan. 3. Redshift Technologies, New York, New York. 4. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 5. Department of Obstetrics and Gynecology, Stanford University, Palo Alto, California. 6. Shady Grove Fertility Center, Washington, District of Columbia. 7. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota. 8. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. 9. Seattle Reproductive Medicine, Seattle, Washington.
Abstract
OBJECTIVE: To develop a model predictive of live-birth rates (LBR) and multiple birth rates (MBR) for an individual considering assisted reproduction technology (ART) using linked cycles from Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) for 2004-2011. DESIGN: Longitudinal cohort. SETTING: Clinic-based data. PATIENT(S): 288,161 women with an initial autologous cycle, of whom 89,855 did not become pregnant and had a second autologous cycle and 39,334 did not become pregnant in the first and second cycles and had a third autologous cycle, with an additional 33,598 women who had a cycle using donor oocytes (first donor cycle). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): LBRs and MBRs modeled by woman's age, body mass index, gravidity, prior full-term births, infertility diagnoses by oocyte source, fresh embryos transferred, and cycle, using backward-stepping logistic regression with results presented as adjusted odds ratios (AORs) and 95% confidence intervals. RESULT(S): The LBRs increased in all models with prior full-term births, number of embryos transferred; in autologous cycles also with gravidity, diagnoses of male factor, and ovulation disorders; and in donor cycles also with the diagnosis of diminished ovarian reserve. The MBR increased in all models with number of embryos transferred and in donor cycles also with prior full-term births. For both autologous and donor cycles, transferring two versus one embryo greatly increased the probability of a multiple birth (AOR 27.25 and 38.90, respectively). CONCLUSION(S): This validated predictive model will be implemented on the Society for Assisted Reproductive Technology Web site (www.sart.org) so that patients considering initiating a course of ART can input their data on the Web site to generate their expected outcomes.
OBJECTIVE: To develop a model predictive of live-birth rates (LBR) and multiple birth rates (MBR) for an individual considering assisted reproduction technology (ART) using linked cycles from Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) for 2004-2011. DESIGN: Longitudinal cohort. SETTING: Clinic-based data. PATIENT(S): 288,161 women with an initial autologous cycle, of whom 89,855 did not become pregnant and had a second autologous cycle and 39,334 did not become pregnant in the first and second cycles and had a third autologous cycle, with an additional 33,598 women who had a cycle using donor oocytes (first donor cycle). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): LBRs and MBRs modeled by woman's age, body mass index, gravidity, prior full-term births, infertility diagnoses by oocyte source, fresh embryos transferred, and cycle, using backward-stepping logistic regression with results presented as adjusted odds ratios (AORs) and 95% confidence intervals. RESULT(S): The LBRs increased in all models with prior full-term births, number of embryos transferred; in autologous cycles also with gravidity, diagnoses of male factor, and ovulation disorders; and in donor cycles also with the diagnosis of diminished ovarian reserve. The MBR increased in all models with number of embryos transferred and in donor cycles also with prior full-term births. For both autologous and donor cycles, transferring two versus one embryo greatly increased the probability of a multiple birth (AOR 27.25 and 38.90, respectively). CONCLUSION(S): This validated predictive model will be implemented on the Society for Assisted Reproductive Technology Web site (www.sart.org) so that patients considering initiating a course of ART can input their data on the Web site to generate their expected outcomes.
Authors: Barbara Luke; Morton B Brown; Judy E Stern; Stacey A Missmer; Victor Y Fujimoto; Richard Leach Journal: Hum Reprod Date: 2010-11-11 Impact factor: 6.918
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Authors: Barbara Luke; Morton B Brown; Ethan Wantman; Judy E Stern; Valerie L Baker; Eric Widra; Charles C Coddington; William E Gibbons; Bradley J Van Voorhis; G David Ball Journal: Am J Obstet Gynecol Date: 2015-02-13 Impact factor: 8.661
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