Clinical factors associated with live birth after single embryo transfer

Kresowik, Jessica D.; Voorhis, Bradley J. Van

doi:10.1016/j.fertnstert.2012.07.1141

Cited by 19 publications

(12 citation statements)

References 25 publications

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“…A potential explanation for this finding may be that, among couples where male factor is the only infertility diagnosis, the female is otherwise healthy and therefore more likely to have a good perinatal outcome. Furthermore, we found uterine factor infertility to be inversely associated with good perinatal outcome, which is consistent with previous studies that demonstrated worsened pregnancy outcomes among patients with uterine factor (11,15). Interestingly, in a previous analysis of national data, Luke and colleagues (31) suggested that the diagnosis of uterine factor was more common among women undergoing elective single ET; however, our data do not support their conclusion.…”

Section: Discussionsupporting

confidence: 75%

“…Previous studies investigating prognostic criteria for elective single ET evaluated the outcomes of clinical pregnancy or live birth (1,11,(17)(18)(19). We chose to focus on having a good perinatal outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Although the greatest increases in the present study were observed among patients less than 35 years of age, for whom ET guidelines currently recommend elective single ET, rates of elective single ET among patients aged 35-37 years have increased by an average of 0.7% per year since 2004, and comprised more than 5% of all transfers in this age group in 2010. This trend suggests that clinicians are expanding the current elective single ET guidelines to include a slightly broader patient population, although it is unclear what prognostic criteria are being used to identify good candidates.Previous studies investigating prognostic criteria for elective single ET evaluated the outcomes of clinical pregnancy or live birth (1,11,(17)(18)(19). We chose to focus on having a good perinatal outcome.…”

mentioning

confidence: 99%

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Elective single embryo transfer trends and predictors of a good perinatal outcome—United States, 1999 to 2010

Steinberg

Boulet

Kissin

et al. 2013

Fertility and Sterility

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Objective-To assess trends in elective single ET and identify factors associated with a good perinatal outcome. Design-Retrospective cohort study.Setting-Clinic-based data. Compared with other ETs, elective single ETs were nearly twice as likely to result in a good perinatal outcome (37.1% vs. 18.9%, respectively). Among women using elective single ET, those aged <35 and 35-37 years had a good perinatal outcome (40.2% and 32.5%, respectively). In multivariable, log-binomial analyses, factors positively associated with a good perinatal outcome included male factor infertility, day 5 ET, and having ≥3 supernumerary embryos for cryopreservation. Between 1999 and, national rates of elective single ET increased. Given the frequency of good perinatal outcomes among women aged 35-37 years, guidelines for elective single ET could be expanded to include patients in this age group with favorable prognoses. Patient(s)- Conclusion(s)-Reprint requests: Marissa L. Steinberg, B.A., Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, Georgia 30341 (MLStei2@emory.edu).. M.L.S. has nothing to disclose. S.B. has nothing to disclose. D.K. has nothing to disclose. L.W. has nothing to disclose. D.J.J. has nothing to disclose. Multiple gestations, and their associated complications, remain the most common adverse outcome associated with assisted reproductive technology (ART). The most effective method for reducing the risk of multiple births after ART is to limit the number of embryos transferred. Evolving practice guidelines from the American Society for Reproductive Medicine (ASRM) and the Society of Assisted Reproductive Technologies (SART) have led to a steady decline in the frequency of higher order (≥3) ETs during the past decade (1). This downward trend has caused an increased number of double ETs, resulting in an unchanged, or even slightly increased, rate of twin gestation resulting from ART (1). Elective single ET, defined as the transfer of only one embryo when more than one high-quality embryo is available, has been proposed as the only means of avoiding multiple gestations after IVF (2). HHS Public AccessAs observed in several studies (3-9), elective single ET successfully reduces the risk of multiple gestations, without significantly compromising live birth rates. However, in prior studies, the population had been restricted to select subsets of patients with the most "favorable prognosis," thereby limiting the generalizability of the findings (3-9). In a study of unselected patients (10), use of elective single ET effectively eliminated multiple gestations, but nearly halved pregnancy rates (PRs), compared with double ETs. Due to low rates of elective single ET in the United States, there has only been one small, single center analysis evaluating factors associated with birth outcomes after fresh elective single ET (11). An analysis of national data would add to this study, which found that younger maternal age and blastocyst expansion were positively associated with clinical pr...

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Elective single embryo transfer trends and predictors of a good perinatal outcome—United States, 1999 to 2010

Steinberg

Boulet

Kissin

et al. 2013

Fertility and Sterility

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“…To the best of our knowledge, no reports have predicted the probability of live birth from images of the blastocyst. One study, however, reported that the live birth rate per transfer was 0.668 based on clinical factors, such as age and body mass index . Another study reported that the grading of the TE was the only statistically significant independent predictor of live birth outcomes and that the live birth probabilities of grade A, B, or C in the TE were 0.499, 0.339, and 0.080, respectively .…”

Section: Discussionmentioning

confidence: 99%

Feasibility of deep learning for predicting live birth from a blastocyst image in patients classified by age

Miyagi

Habara

Hirata

et al. 2019

Reprod Medicine & Biology

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Purpose To identify artificial intelligence (AI) classifiers in images of blastocysts to predict the probability of achieving a live birth in patients classified by age. Results are compared to those obtained by conventional embryo (CE) evaluation. Methods A total of 5691 blastocysts were retrospectively enrolled. Images captured 115 hours after insemination (or 139 hours if not yet large enough) were classified according to maternal age as follows: <35, 35‐37, 38‐39, 40‐41, and ≥42 years. The classifiers for each category and a classifier for all ages were related to convolutional neural networks associated with deep learning. Then, the live birth functions predicted by the AI and the multivariate logistic model functions predicted by CE were tested. The feasibility of the AI was investigated. Results The accuracies of AI/CE for predicting live birth were 0.64/0.61, 0.71/0.70, 0.78/0.77, 0.81/0.83, 0.88/0.94, and 0.72/0.74 for the age categories <35, 35‐37, 38‐39, 40‐41, and ≥42 years and all ages, respectively. The sum value of the sensitivity and specificity revealed that AI performed better than CE ( P = 0.01). Conclusions AI classifiers categorized by age can predict the probability of live birth from an image of the blastocyst and produced better results than were achieved using CE.

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“…So far, the number of Follicle Stimulating Hormone (FSH) International Units (IU) administered during the stimulation protocol [6,7], elevated Body Mass Index (BMI) [7,8], older female age [8,9], active cigarette smoking [8] and uterine factor [9] are the main parameters relative to infertile women which have already been statistically associated with a decrease in either ongoing pregnancy [6,7,9] or healthy term birth [8,9] after eSET. However, there is a relatively weak agreement between these conclusions, probably because of a great variability in the size and the characteristics of the study population, the stimulation and transfer strategies, and the clinical or demographical factors analyzed.…”

Section: Introductionmentioning

confidence: 99%

Clinical predictive criteria associated with live birth following elective single embryo transfer

Sifer

Herbemont

Adda-Herzog

et al. 2014

European Journal of Obstetrics & Gynecology and Reproductiv

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Clinical factors associated with live birth after single embryo transfer

Cited by 19 publications

References 25 publications

Elective single embryo transfer trends and predictors of a good perinatal outcome—United States, 1999 to 2010

Elective single embryo transfer trends and predictors of a good perinatal outcome—United States, 1999 to 2010

Feasibility of deep learning for predicting live birth from a blastocyst image in patients classified by age

Clinical predictive criteria associated with live birth following elective single embryo transfer

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