Probability of ongoing pregnancy after in vitro fertilization (IVF)- embryo transfer (ET).
This model model is intended to estimate the probability of ongoing pregnancy after in vitro fertilization (IVF)-embryo transfer (ET) using age of women and serum biomarkers (c-index: 0.91). This model needs further validation to improve individualized prediction of ongoing pregnancy.

Research authors: Kim JH, Jee BC, Suh CS, Kim SH.
Details Formula Study characteristics Files & References
Model author
Model ID
346
Version
1.5
Revision date
2016-06-26
Specialty
MeSH terms
  • In Vitro Fertilization
  • Fertilization in Vitro
  • Pregnancy
  • Embryo Transfer
  • Model type
    Logistic regression (Calculation)
    Status
    public
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    Formula
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    Condition Formula

    Additional information

    Prospective longitudinal study of 103 patients undergoing IVF-ET at a university-based hospital. Serum HCG and progesterone levels were measured at the time of the pregnancy test (14 days after oocyte retrieval) and pregnancy outcomes were followed. The main outcome was ongoing pregnancy prediction.

    Simple and multiple logistic regression analyses were performed to test the association between ongoing pregnancy and age, serum HCG and progesterone levels, respectively, and to assess the joint effect of variables. To assess the predictive accuracy and estimate the sensitivity and specificity values for each, and combinations of the variables, receiver-operating characteristic (ROC) curves were generated. On the basis of these predictive factors, a nomogram was constructed to predict ongoing pregnancy.

    Study Population

    Total population size: 103
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Pregnancy outcomes Non-pregnancy 60
    Chemical pregnancy 8
    Clinical abortion 5
    Ectopic pregnancy 2
    Ongoing pregnancy (singleton) 20
    Ongoing pregnancy (multifetal) 8

    Probability of ongoing pregnancy in IVF-ET cycles:
    ...

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    Result
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    Probability of ongoing pregnancy in IVF-ET cycles:

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    Outcome stratification

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    Conditional information

    Result interpretation

    This model was build to predict ongoing pregnancy in IVF cycles using age of women and serum HCG and progesterone levels measured at 14 days post-OPU. The nomogram may provide a better discrimination than HCG alone and give help to individualized prediction of ongoing pregnancy. For the generalized use of this nomogram, further validation by large data sets is required. We believe that this nomogram can be useful in counseling IVF patients.

    Model performance:
    With a combination of serum HCG, progesterone and age of woman, the predictive accuracy of the model was: AUC 0.912 (95% CI 0.815–1.000), sensitivity 89.3%, specificity 80.0%, PPV 89.3%, NPV 80.0%.
     
    Note: like the age of woman, supraphysiologically high levels of progesterone appears to be related to poor maintenance of viable gestational sac. On the contrary, a relatively low level of progesterone might also contribute to poor pregnancy results, thus increment of progesterone supplementation should be considered in the next IVF cycle in these women. Further prospective studies are needed to elucidate the effect of progesterone increment on improved pregnancy rate in these women.



    Source:
    Kim JH, Jee BC, Suh CS, Kim SH. Nomogram to predict ongoing pregnancy using age of women and serum biomarkers after in vitro fertilization cycles. Eur J Obstet Gynecol Reprod Biol. 2014;172:65-69.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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