The following is a summary of “Predicted probabilities of live birth following assisted reproductive technology using United States national surveillance data from 2016 to 2018,” published in the MAY 2023 issue of Obstetrics and Gynecology by Gaskins, et al.
The use of in vitro fertilization (IVF) is increasing in the United States, and accurate models that estimate cumulative live birth rates after multiple oocyte retrievals and embryo transfers (both fresh and frozen) are valuable for patients and clinicians in making treatment decisions. For a study, researchers sought to develop models that predict the probability of live birth in individuals considering IVF, based on their demographic and reproductive characteristics.
A population-based cohort study was conducted using data from the National Assisted Reproductive Technology Surveillance System from 2016 to 2018. The study included 196,916 women who underwent 207,766 autologous embryo transfer cycles and 25,831 women who underwent 36,909 donor oocyte transfer cycles. Models were developed using data from autologous IVF cycles to estimate the cumulative live birth rate after all embryo transfers within 12 months following 1, 2, and 3 oocyte retrievals for new and returning patients. For patients using donor oocytes, the cumulative live birth rate after the first, second, and third embryo transfers was estimated. Multinomial logistic regression models adjusted for various factors such as age, body mass index, parity, gravidity, and infertility diagnoses to estimate the cumulative live birth rate.
Among new and returning patients undergoing autologous IVF, the age of the female partner had the strongest association with the cumulative live birth rate. Lower body mass index and parity or gravidity ≥1 were associated with higher cumulative live birth rates, although results were inconsistent. Infertility diagnoses such as diminished ovarian reserve, uterine factor, and other reasons were associated with lower cumulative live birth rates, while male factors, tubal factors, ovulatory disorders, and unexplained infertility were associated with higher cumulative live birth rates. The models provided estimated cumulative live birth rates based on different patient characteristics. For example, a new patient who is 35 years old, with a body mass index of 25 kg/m2, no previous pregnancy, and unexplained infertility diagnoses, has a 48%, 69%, and 80% cumulative live birth rate after the first, second, and third oocyte retrieval, respectively. Cumulative live birth rates were lower for patients with diminished ovarian reserve or older age.
The developed models provided estimates of the cumulative live birth rate based on demographic and reproductive characteristics, which can assist patients and providers in understanding the probability of success after IVF. These models can help inform treatment decisions and discussions between patients and healthcare providers.
Source: ajog.org/article/S0002-9378(23)00021-2/fulltext
