Patient-specific predictions of outcome after gonadotropin ovulation induction/intrauterine insemination  Randi H. Goldman, M.D., Maria Batsis, M.D.,

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Presentation transcript:

Patient-specific predictions of outcome after gonadotropin ovulation induction/intrauterine insemination  Randi H. Goldman, M.D., Maria Batsis, M.D., John C. Petrozza, M.D., Irene Souter, M.D.  Fertility and Sterility  Volume 101, Issue 6, Pages 1649-1655.e2 (June 2014) DOI: 10.1016/j.fertnstert.2014.02.028 Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 1 (A) For each outcome, the patient-specific and cycle-specific parameters were stratified. Stratifications include age (<35, 35–37, 38–40, 41–42, ≥43 years), body mass index (BMI) (<25, 25–30, 30–35, >35 kg/m2), the number of follicles ≥13 mm (<2 or ≥2), E2 level the day before (<350, 350–500, >500 pg/mL) and the day of (<400, 400–650, >650 pg/mL) hCG administration, day 3 FSH (<6, 6–8, >8 IU/L), cycle number (1, 2, 3, 4, 5, ≥6), and total gonadotropin dose (<750, 750–1,499, ≥1,500 IU). Spontaneous abortion rate (SART) diagnoses included ovulatory dysfunction (ov. dys.), diminished ovarian reserve (DOR), male factor infertility, tubal factor, single parent/same sex relationship (single/ss), and “other.” A separate “combined” category for patients with multiple primary diagnoses was included separately for ease of comparison. CPR = clinical pregnancy rate; MPR = multiple pregnancy rate. (B) Crude (red) and adjusted (blue) odds ratios for each stratification wherein age <35years, BMI <25 kg/m2, follicles ≥13 mm <2, E2 level on the day before hCG administration <350 pg/mL, E2 level on the day of hCG administration <400 pg/mL, day 3 FSH <6 IU/L, cycle number 1, gonadotropin dose <750 IU, and a diagnosis of “other” defined the referent values for ease of comparison. Fertility and Sterility 2014 101, 1649-1655.e2DOI: (10.1016/j.fertnstert.2014.02.028) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Receiver operating characteristic curves for clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), and spontaneous abortion rate (SABR). For each graph, the red curve represents the outcome of the model using age (for CPR and SABR) and age and E2 for MPR. The blue curve represents the outcome of the model using all significant or nearly significant (P<.25) patient and cycle characteristics. Fertility and Sterility 2014 101, 1649-1655.e2DOI: (10.1016/j.fertnstert.2014.02.028) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Screenshot of a web applet using logistic regressions to estimate clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), and spontaneous abortion rate (SABR) after IUI. (A, B) Sample data and predicted rates for two patients. The applet is intended for use by physicians and patients. BMI = body mass index; DOR = diminished ovarian reserve. Fertility and Sterility 2014 101, 1649-1655.e2DOI: (10.1016/j.fertnstert.2014.02.028) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions