Application of a validated prediction model for in vitro fertilization: comparison of live birth rates and multiple birth rates with 1 embryo transferred over 2 cycles vs 2 embryos in 1 cycle - 27/04/15
, Morton B. Brown, PhD b, Ethan Wantman, MBA c, Judy E. Stern, PhD d, Valerie L. Baker, MD e, Eric Widra, MD f, Charles C. Coddington, MD g, William E. Gibbons, MD h, Bradley J. Van Voorhis, MD i, G. David Ball, PhD jAbstract |
Objective |
The purpose of this study was to use a validated prediction model to examine whether single embryo transfer (SET) over 2 cycles results in live birth rates (LBR) comparable with 2 embryos transferred (DET) in 1 cycle and reduces the probability of a multiple birth (ie, multiple birth rate [MBR]).
Study Design |
Prediction models of LBR and MBR for a woman considering assisted reproductive technology developed from linked cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System for 2006-2012 were used to compare SET over 2 cycles with DET in 1 cycle. The prediction model was based on a woman’s age, body mass index (BMI), gravidity, previous full-term births, infertility diagnoses, embryo state, number of embryos transferred, and number of cycles.
Results |
To demonstrate the effect of the number of embryos transferred (1 or 2), the LBRs and MBRs were estimated for women with a single infertility diagnosis (male factor, ovulation disorders, diminished ovarian reserve, and unexplained); nulligravid; BMI of 20, 25, 30, and 35 kg/m2; and ages 25, 35, and 40 years old by cycle (first or second). The cumulative LBR over 2 cycles with SET was similar to or better than the LBR with DET in a single cycle (for example, for women with the diagnosis of ovulation disorders: 35 years old; BMI, 30 kg/m2; 54.4% vs 46.5%; and for women who are 40 years old: BMI, 30 kg/m2; 31.3% vs 28.9%). The MBR with DET in 1 cycle was 32.8% for women 35 years old and 20.9% for women 40 years old; with SET, the cumulative MBR was 2.7% and 1.6%, respectively.
Conclusion |
The application of this validated predictive model demonstrated that the cumulative LBR is as good as or better with SET over 2 cycles than with DET in 1 cycle, while greatly reducing the probability of a multiple birth.
Le texte complet de cet article est disponible en PDF.Key words : assisted reproductive technology, live birth, multiple birth, prediction model
Plan
| Supported by Award Number R01 CA151973 from the National Cancer Institute, National Institute of Child Health and Human Development, and the National Institute of Nursing Research (B.L. and M.B.B.). |
|
| B.L. is a consultant to the Society for Assisted Reproductive Technology; E.W. is under contract with the Society for Assisted Reproductive Technology as a data vendor. All other authors report no conflict of interest. |
|
| The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institute of Child Health and Human Development, the National Institute of Nursing Research, or the National Institutes of Health. |
|
| The racing flag logo above indicates that this article was rushed to press for the benefit of the scientific community. |
|
| Cite this article as: Luke B, Brown MB, Wantman E, et al. Application of a validated prediction model for in vitro fertilization: comparison of live birth rates and multiple birth rates with 1 embryo transferred over 2 cycles vs 2 embryos in 1 cycle. Am J Obstet Gynecol 2015;212:676.e1-7. |
Vol 212 - N° 5
P. 676.e1-676.e7 - mai 2015 Retour au numéro
Article précédent
- Surgery without consent or miscommunication? A new look at a landmark legal case
- Judith Chervenak, Laurence B. McCullough, Frank A. Chervenak
- Laparoscopic hysterectomy with morcellation vs abdominal hysterectomy for presumed fibroid tumors in premenopausal women: a decision analysis
- Matthew T. Siedhoff, Stephanie B. Wheeler, Sarah E. Rutstein, Elizabeth J. Geller, Kemi M. Doll, Jennifer M. Wu, Daniel L. Clarke-Pearson
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?