Prognostic value of the postcoital test for spontaneous pregnancy
| Autor: | Ben W.J. Mol, Jur Oosterhuis, Peter G.A. Hompes, Petra Bourdrez, Fulco van der Veen, Esther Leushuis, Carolien A.M. Koks, Jan Willem van der Steeg, Pieternel Steures, Patrick M.M. Bossuyt |
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| Přispěvatelé: | Obstetrics and gynaecology, ICaR - Ischemia and repair, Amsterdam Public Health, Center for Reproductive Medicine, Other departments, Epidemiology and Data Science, Amsterdam Reproduction & Development (AR&D), Obstetrics and Gynaecology, Obstetrie & Gynaecologie, RS: GROW - School for Oncology and Reproduction |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pregnancy test medicine.medical_specialty Time Factors Pregnancy Tests Cohort Studies hazard ratio Predictive Value of Tests Pregnancy parasitic diseases Humans Medicine Prospective cohort study Gynecology business.industry Hazard ratio Coitus Obstetrics and Gynecology medicine.disease Postcoital test net reclassification improvement Confidence interval prediction model Reproductive Medicine Predictive value of tests Calibration Female prognosis business Algorithms hormones hormone substitutes and hormone antagonists Follow-Up Studies Cohort study |
| Zdroj: | Leushuis, E, van der Steeg, J W, Steures, P, Koks, C, Oosterhuis, J, Bourdrez, P, Bossuyt, P M M, van der Veen, F, Mol, B W J & Hompes, P G A 2011, ' Prognostic value of the postcoital test for spontaneous pregnancy ', Fertility and Sterility, vol. 95, no. 6, pp. 2050-2055 . https://doi.org/10.1016/j.fertnstert.2011.02.038 Fertility and Sterility, 95(6), 2050-2055. Elsevier Inc. Fertility and sterility, 95(6), 2050-2055. Elsevier Inc. Fertility and Sterility, 95(6), 2050-2055. Elsevier Science |
| ISSN: | 0015-0282 |
| Popis: | Objective: To evaluate the capacity of the postcoital test (PCT) to predict spontaneous pregnancy in a large cohort study of subfertile couples. Design: Prospective study. Setting: Department of reproductive medicine of 38 hospitals in the Netherlands. Patient(s): Between January 2002 and February 2004, we prospectively included consecutive subfertile couples who had not been evaluated previously for subfertility. Intervention(s): We estimated the contribution of the PCT result to the existing prediction model for spontaneous pregnancy by calculating the adjusted hazard ratio (HR) of an abnormal PCT result. We constructed a second prediction model (PCT model) based on the reference model including the PCT. Main Outcome Measure(s): Primary endpoint in this study was ongoing pregnancy. We evaluated the performance of the PCT model in comparison with the reference model by calculating goodness of fit, discrimination, calibration, and the "net reclassification improvement''. Result(s): We included 3,021 couples of whom537 (18%) had a spontaneous pregnancy and 55 (1.8%) a nonsuccessful pregnancy; 1,316 (44%) started treatment within 12months, 824 (27%) neither started treatment nor became pregnant, and 289 (10%) became lost to follow-up within 12 months. The adjusted HR for an abnormal PCTwas 0.76 (95% confidence interval [CI]: 0.62 to 0.94). The adjustedHRfor an abnormal PCTwas 0.63 (95% CI: 0.47 to 0.84) in case of no spermatozoa, 0.81 (95% CI: 0.57 to 1.2) in case of nonmotile spermatozoa, and 1.2 (95% CI: 0.8 to 1.8) in case of motile, nonprogressive spermatozoa. Adding the PCT result to the reference model did not improve goodness of fit. Discrimination was equally poor for the PCT model and the reference model. The calibration plots of both models showed comparably good calibration. The net reclassification improvement of the predictions of the PCT model compared with the reference model was -1.1%. Conclusion(s): This study demonstrated that the PCT has prognostic value but does not add substantially to a prognostic model for spontaneous pregnancy. (Fertil Steril (R) 2011; 95:2050-5. (C) 2011 byAmerican Society for Reproductive Medicine.) |
| Databáze: | OpenAIRE |
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