Nomogram to predict pregnancy rate after ICSI–IVF cycle in patients with endometriosis  

Oleh:

Ballester, Marcos ; Oppenheimer, Anne ; d'Argent, Emmanuelle Mathieu ; Touboul, Cyril

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Human Reproduction vol. 27 no. 02 (Feb. 2012), page 451-456.
Topik: INFERTILITY; IVF; Endometriosis; Nomogram; Prediction Models; Pregnancy

Ketersediaan

Perpustakaan FK Nomor Panggil: H07.K.2012.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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BACKGROUND Although several scoring systems have been published to evaluate the pregnancy rate after ICSI–IVF in infertile patients, none of them are applicable for patients with deep infiltrating endometriosis (DIE) nor can they evaluate the chances of pregnancy for individual patients. The aim of this study was to develop a nomogram based on an association of patients' characteristics to predict the clinical pregnancy rate in patients with endometriosis. METHODS This prospective longitudinal study was conducted from January 2007 to June 2010. The nomogram was built from a training cohort of 94 consecutive patients (141 ICSI–IVF cycles) and tested on an independent validation cohort of 48 patients (83 ICSI–IVF cycles). DIE was confirmed in all participants. RESULTS The pregnancy rate (per patient) in women with and without DIE was 58 and 83%, respectively (P = 0.03). Increased patient age (P = 0.04), serum anti-Mullerian hormone (AMH) level =1 ng/ml (P = 0.03) and increased number of ICSI–IVF cycles (P = 0.03) were associated with a decreased clinical pregnancy rate. The presence of DIE was the strongest determinant factor of the clinical pregnancy rate in our model [odds ratio = 0.26, 95% confidence interval (CI): 0.07–0.9 (P = 0.006)], which also included patient age, serum AMH level and number of attempts at ICSI–IVF. The nomogram showed an area under the curve (AUC) of 0.76 for the training cohort (95% CI: 0.7–0.8) and was well calibrated. The AUC for the validation cohort was 0.68 (95% CI: 0.6–0.75) and calibration was good. CONCLUSIONS Our nomogram provides realistic and precise information about ICSI–IVF success and can be used to guide couples and practitioners. Key words

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