Predicting personalized multiple birth risks after in vitro fertilization–double embryo transfer
| Autor: | C. Brent Barrett, Wing Hung Wong, Mylene W.M. Yao, Michele R. Hacker, Laura E. Dodge, B.A. Malizia, B.M. Lannon, Bokyung Choi, Alan S. Penzias |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Individuality Fertilization in Vitro Multiple Birth Offspring Pregnancy Risk Factors medicine Humans Double embryo transfer education Probability Retrospective Studies Gynecology education.field_of_study Models Statistical In vitro fertilisation Obstetrics business.industry Obstetrics and Gynecology Embryo Transfer Prognosis Embryo transfer Treatment Outcome Standard error Reproductive Medicine Infertility Predictive power Female Multiple birth Pregnancy Multiple business Predictive modelling Forecasting |
| Zdroj: | Fertility and Sterility. 98:69-76 |
| ISSN: | 0015-0282 |
| Popis: | Objective To report and evaluate the performance and utility of an approach to predicting IVF–double embryo transfer (DET) multiple birth risks that is evidence-based, clinic-specific, and considers each patient's clinical profile. Design Retrospective prediction modeling. Setting An outpatient university-affiliated IVF clinic. Patient(s) We used boosted tree methods to analyze 2,413 independent IVF-DET treatment cycles that resulted in live births. The IVF cycles were retrieved from a database that comprised more than 33,000 IVF cycles. Intervention(s) None. Main Outcome Measure(s) The performance of this prediction model, MBP-BIVF, was validated by an independent data set, to evaluate predictive power, discrimination, dynamic range, and reclassification. Result(s) Multiple birth probabilities ranging from 11.8% to 54.8% were predicted by the model and were significantly different from control predictions in more than half of the patients. The prediction model showed an improvement of 146% in predictive power and 16.0% in discrimination over control. The population standard error was 1.8%. Conclusion(s) We showed that IVF patients have inherently different risks of multiple birth, even when DET is specified, and this risk can be predicted before ET. The use of clinic-specific prediction models provides an evidence-based and personalized method to counsel patients. |
| Databáze: | OpenAIRE |
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