A nomogram to predict the probability of live birth after clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility

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Presentation transcript:

A nomogram to predict the probability of live birth after clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility Babak Imani, M.D., Marinus J.C Eijkemans, M.Sc., Egbert R te Velde, M.D., Ph.D., J.Dik F Habbema, M.D., Ph.D., Bart C.J.M Fauser, M.D., Ph.D. Fertility and Sterility Volume 77, Issue 1, Pages 91-97 (January 2002) DOI: 10.1016/S0015-0282(01)02929-6

FIGURE 1 Cumulative percentage of women reaching first ovulation and first conception ending in a live birth in 259 normogonadotropic oligoamenorrheic infertile patients treated with CC therapy. Solid line = first ovulation after CC administration (n = 194; 75%); dashed line = first conception ending in a live birth (n = 98; 38%). Imani. Prediction outcome clomiphene induction. Fertil Steril 2002. Fertility and Sterility 2002 77, 91-97DOI: (10.1016/S0015-0282(01)02929-6)

FIGURE 2 The impact of cycle history on cumulative ovulation (A) and live birth (B) rates in 259 normogonadotropic oligoamenorrheic infertile patients treated with CC therapy. Solid line = oligomenorrheic patients (n = 197). P<.001. Dashed line = amenorrheic patients (n = 62). P = not applicable in the overall WHO 2 anovulatory patients. P<.001 in ovulatory patients following CC therapy. P values represent differences applying log rank test. Imani. Prediction outcome clomiphene induction. Fertil Steril 2002. Fertility and Sterility 2002 77, 91-97DOI: (10.1016/S0015-0282(01)02929-6)

FIGURE 3 The probability of ovulation and conception ending in a live birth within 6 months after initiation of CC therapy applying a nomogram. Chances for ovulation following CC administration can be assessed using FAI, BMI, and cycle history (left panel). The probability of conception ending in a live birth within 6 months after initiation of CC therapy can be assessed by combining the probability to ovulate with the age and the cycle history of the woman (right panel). To use this nomogram, encircle the values related to each screening parameter. Connect the circles to observe the predicted probability to ovulate. Correspond this probability from the left to the right panel, and connect it with the woman’s age (separately for oligomenorrhea or amenorrhea) to predict the chance of a live birth. For instance, a 29-year-old amenorrheic woman presented with the following findings: FAI = 9.3, BMI = 32. Her chance to conceive leading to a live birth within 6 months after initiation of CC medication will be 19% (chance to ovulate following CC therapy: 50%). Imani. Prediction outcome clomiphene induction. Fertil Steril 2002. Fertility and Sterility 2002 77, 91-97DOI: (10.1016/S0015-0282(01)02929-6)