Embryo and uterine influences on IVF outcomes: an analysis of a UK multi-centre cohort

Abstract

The EU modelling framework has generated a model for predicting outcomes of embryo-transfer procedures, subject to the limitations of routinely collected data. With this large data set, the model allows identification of factors that act specifically on embryo viability or maternal receptivity. Variability in the two components between centres with similar overall outcomes suggests scope for further optimization of IVF treatment.

A Bayesian network model for predicting pregnancy after in vitro fertilization

“…The AUCs do not significantly change if the averaging or the MAP approach are used to estimate parameters. The reported AUCs are in line with or slightly better than those reported in recent state-of-the-art studies, such as [12]. The AUCs do not significantly improve if one of the more complex structures listed in Table 2 is adopted instead of BN 1 ; this confirms the reliability of the BIC analysis.…”

“…accepted within the IVF community [8,12]. Moreover, they clearly support the introduction of the top-history score: embryos scored as top-history have significantly higher chance of implantation of embryos which are simply graded as top in the last observation.…”

“…Structures 1-4 refer to BN 1 , BN 2 and other structures which are intermediate among the two. Structure 5 implements the idea of age impacting on embryo viability rather than on uterus receptivity, suggested in [12]. Structures 6 and 7 use the day of the transfer (discretized as {2-3, 4-5}), besides the category, to characterize the viability of the embryo: e.g., this structure allows an embryo scored as top-history on day 2-3 to have different viability from an embryo scored as top-history on day 4-5.…”

“…Therefore, in [11] the model has been reworked (adopting a generalized linear model framework) by letting vary both θ u and θ e on external covariates; in particular, by letting θ u depend on the age of the woman and θ e on the number of cells present in the embryo at a given day (this is a marker of implantation capability). More recently it has been investigated [12] how to select the number and the types of covariates on which θ u and θ e should depend. In fact, quantifying how uterine receptivity and embryo viability vary as a function of respectively e.g.…”

Elective Single Embryo Transfer: an update to UK Best Practice Guidelines

“…although the evidence suggests that oocyte aneuploidy is the biggest limiting factor in older women, there is also some decline in uterine receptivity (legro et al, 1995;Stolwijk et al, 1997;toner et al, 2002;roberts et al, 2010a). more significantly, repeat egg collections following failure will occur at later ages in an eSet programme, reducing the chances of a successful outcome.…”