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Yang H, Liu F, Ma Y, Di M. Clinical pregnancy outcomes prediction in vitro fertilization women based on random forest prediction model: A nested case-control study. Medicine (Baltimore) 2022; 101:e32232. [PMID: 36626443 PMCID: PMC9750545 DOI: 10.1097/md.0000000000032232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The present study aimed to analyze the risk factors influencing the in vitro fertilization embryo transfer (IVF-ET) pregnancy and to construct a prediction model for clinical pregnancy outcome in patients receiving IVF-ET based on the predictors. In this nested case-control study, the data of 369 women receiving IVF-ET were enrolled. Univariate and multivariate Logistic regression analyses were conducted to identify the potential predictors. Ten-fold cross validation method was used to validate the random forest model for predicting the clinical pregnancy. The receiver operating characteristic curve was drawn to evaluate the prediction ability of the model. The importance of variables was shown according to Mean Decrease Gini. The data delineated that age (odds ratio [OR]= 1.093, 95% confidence interval [CI]: 1.036-1.156, P = .0010), body mass index (BMI) (OR = 1.094, 95%CI: 1.021-1.176, P = .012), 3 cycles (OR = 0.144, 95%CI: 0.028-0.534, P = .008), hematocrit (HCT) (OR = 0.865, 95% CI: 0.791-0.943, P = .001), luteinizing hormone (LH) (OR = 0.678, 95%CI: 0.549-0.823, P < .001), progesterone (P) (OR = 2.126, 95%CI: 1.112-4.141, P = .024), endometrial thickness (OR = 0.132, 95%CI: 0.034-0.496, P = .003) and FSH (OR = 1.151, 95%CI: 1.043-1.275, P = .006) were predictors associated with the clinical pregnancy outcome of patients receiving IVF-ET. The results might provide a novel method to identify patients receiving IVF-ET with a high risk of poor pregnancy outcomes and provide interventions in those patients to prevent the occurrence of poor pregnancy outcomes.
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Affiliation(s)
- Hongya Yang
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Fang Liu
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Yuan Ma
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province, China
| | - Man Di
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province, China
- * Correspondence: Man Di, Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, No. 569, Xinsi Road, Baqiao District, Xi’an, Shaanxi Province 710038 China (e-mail: )
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Ranisavljevic N, Huberlant S, Montagut M, Alonzo PM, Darné B, Languille S, Anahory T, Cédrin-Durnerin I. Low Luteal Serum Progesterone Levels Are Associated With Lower Ongoing Pregnancy and Live Birth Rates in ART: Systematic Review and Meta-Analyses. Front Endocrinol (Lausanne) 2022; 13:892753. [PMID: 35757393 PMCID: PMC9229589 DOI: 10.3389/fendo.2022.892753] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/29/2022] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Progesterone plays a key role in implantation. Several studies reported that lower luteal progesterone levels might be related to decreased chances of pregnancy. This systematic review was conducted using appropriate key words, on MEDLINE, EMBASE, and the Cochrane Library, from 1990 up to March 2021 to assess if luteal serum progesterone levels are associated with ongoing pregnancy (OP) and live birth (LB) rates (primary outcomes) and miscarriage rate (secondary outcome), according to the number of corpora lutea (CLs). Overall 2,632 non-duplicate records were identified, of which 32 relevant studies were available for quantitative analysis. In artificial cycles with no CL, OP and LB rates were significantly decreased when the luteal progesterone level falls below a certain threshold (risk ratio [RR] 0.72; 95% confidence interval [CI] 0.62-0.84 and 0.73; 95% CI 0.59-0.90, respectively), while the miscarriage rate was increased (RR 1.48; 95% CI 1.17-1.86). In stimulated cycles with several CLs, the mean luteal progesterone level in the no OP and no LB groups was significantly lower than in the OP and LB groups [difference in means 68.8 (95% CI 45.6-92.0) and 272.4 (95% CI 10.8-533.9), ng/ml, respectively]. Monitoring luteal serum progesterone levels could help in individualizing progesterone administration to enhance OP and LB rates, especially in cycles without corpus luteum. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139019, identifier 139019.
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Affiliation(s)
- Noemie Ranisavljevic
- Department of Reproductive Medicine, Centre Hospitalier Universitaire (CHU) and University of Montpellier, Montpellier, France
- *Correspondence: Noemie Ranisavljevic,
| | - Stephanie Huberlant
- Department of Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Carémeau, Nîmes, France
| | - Marie Montagut
- Center for Human Reproduction-Institut Francophone de Recherche Et d’études Appliquées à la Reproduction Et Sexologie (IFREARES), Clinique Saint Jean du Languedoc, Toulouse, France
| | | | | | | | - Tal Anahory
- Department of Reproductive Medicine, Centre Hospitalier Universitaire (CHU) and University of Montpellier, Montpellier, France
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Wang Z, Gao Y, Zhang D, Li Y, Luo L, Xu Y. Predictive value of serum β-human chorionic gonadotropin for early pregnancy outcomes. Arch Gynecol Obstet 2019; 301:295-302. [PMID: 31758302 DOI: 10.1007/s00404-019-05388-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 11/14/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the relationship between serum β-human chorionic gonadotropin (HCG) levels and early pregnancy outcomes in women who became pregnant using assisted reproductive technologies (ARTs). METHODS In this study, we retrospectively analyzed 523 pregnancies after ART use, with respect to the early clinical outcomes based on the serum β-HCG levels. The significance of using serum β-HCG levels to predict outcomes in early pregnancy was evaluated by the receiver operating characteristic (ROC) curve and cutoff values of serum β-HCG. RESULTS We found that elevated serum β-HCG levels resulted in decreased biochemical pregnancy rates, increased multiple rates, and decreased ongoing and ectopic pregnancy rates. The cutoff values of serum β-HCG levels for the prediction of biochemical pregnancy were 213.15 IU/L, 986.65 IU/L, and 2206.5 IU/L for singletons, multiples, and twins or triplets, respectively. CONCLUSION The serum β-HCG level 14 or 12 days after D3 or D5 embryo transfer (conducted 3 or 5 days after oocyte retrieval), respectively, predicts biochemical/clinical pregnancy and singleton/multiple pregnancy with robust sensitivity and specificity.
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Affiliation(s)
- Zengyan Wang
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China.
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China.
| | - Yong Gao
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
| | - Dan Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
| | - Yubin Li
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
| | - Lu Luo
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China
| | - Yanwen Xu
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China.
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, No. 58, Guangzhou, 510080, Guangdong, China.
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