Adaptive data-driven models to best predict the likelihood of live birth as the IVF cycle moves on and for each embryo transfer

Abstract

Purpose To dynamically assess the evolution of live birth predictive factors’ impact throughout the in vitro fertilization (IVF) process, for each fresh and subsequent frozen embryo transfers. Methods In this multicentric study, data from 13,574 fresh IVF cycles and 6,770 subsequent frozen embryo transfers were retrospectively analyzed. Fifty-seven descriptive parameters were included and split into four categories: (1) demographic (couple’s baseline characteristics), (2) ovarian stimulation, (3) laboratory data, and (4) embryo transfer (fresh and frozen). All these parameters were used to develop four successive predictive models with the outcome being a live birth event. Results Eight parameters were predictive of live birth in the first step after the first consultation, 9 in the second step after the stimulation, 11 in the third step with laboratory data, and 13 in the 4th step at the transfer stage. The predictive performance of the models increased at each step. Certain parameters remained predictive in all 4 models while others were predictive only in the first models and no longer in the subsequent ones when including new parameters. Moreover, some parameters were predictive in fresh transfers but not in frozen transfers. Conclusion This work evaluates the chances of live birth for each embryo transfer individually and not the cumulative outcome after multiple IVF attempts. The different predictive models allow to determine which parameters should be taken into account or not at each step of an IVF cycle, and especially at the time of each embryo transfer, fresh or frozen.

Nonlinear relationship between gonadotropin total dose applied and live birth rates in non-PCOS patients: a retrospective cohort study

“…Therefore, this study found a negative correlation in pregnancy outcome when the total FSH dose exceeded a certain dose. It was also found that frozen embryo transfer reversed the adverse influence of high FSH on LBR in fresh cycles, indirectly suggesting that it may be the endometrium receptivity that is adversely affected by the FSH dose 51 , 52 . Nevertheless, the mechanisms by which high FSH doses alter follicular development and endometrial tolerance need to be further explored.…”