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Fertil Steril. 2012 Jul;98(1):69-76. doi: 10.1016/j.fertnstert.2012.04.011. Epub 2012 Jun 4.

Predicting personalized multiple birth risks after in vitro fertilization-double embryo transfer.

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1
Boston IVF, Waltham, Massachusetts, USA.

Abstract

OBJECTIVE:

To report and evaluate the performance and utility of an approach to predicting IVF-double embryo transfer (DET) multiple birth risks that is evidence-based, clinic-specific, and considers each patient's clinical profile.

DESIGN:

Retrospective prediction modeling.

SETTING:

An outpatient university-affiliated IVF clinic.

PATIENT(S):

We used boosted tree methods to analyze 2,413 independent IVF-DET treatment cycles that resulted in live births. The IVF cycles were retrieved from a database that comprised more than 33,000 IVF cycles.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

The performance of this prediction model, MBP-BIVF, was validated by an independent data set, to evaluate predictive power, discrimination, dynamic range, and reclassification.

RESULT(S):

Multiple birth probabilities ranging from 11.8% to 54.8% were predicted by the model and were significantly different from control predictions in more than half of the patients. The prediction model showed an improvement of 146% in predictive power and 16.0% in discrimination over control. The population standard error was 1.8%.

CONCLUSION(S):

We showed that IVF patients have inherently different risks of multiple birth, even when DET is specified, and this risk can be predicted before ET. The use of clinic-specific prediction models provides an evidence-based and personalized method to counsel patients.

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