Estimating cumulative live-birth rates after IVF treatment with Kaplan–Meier and competing risk methods

Viardot-Foucault, Véronique; Tai, Bee Choo; Chen, Zhao Jin; Lim, Gek Hsiang; Loh, Seong Feei; Tan, Heng Hao; Nadarajah, Sadhana; Chan, Jerry Kok Yen

doi:10.1016/j.ejogrb.2015.06.015

Cited by 8 publications

(5 citation statements)

References 39 publications

(53 reference statements)

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“…This is consistent with previous publications demonstrating the negative effect of maternal age on LBRs in ART. 7 Age is the single most important factor in determining success rates after IVF, 8 with success rates diminishing greatly after the age of 40. 9 In our study, there was a significant decrease in CPR with age.…”

Section: Resultsmentioning

confidence: 99%

Comparison between Single and Double Cleavage-Stage Embryo Transfers, Single and Double Blastocyst Transfers in a South East Asian In Vitro Fertilisation Centre

Kwek

Saffari

Tan

et al. 2018

Ann Acad Med Singap

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Introduction: This study investigated the differences in clinical pregnancy rate (CPR), live birth rate (LBR) and multiple pregnancy rate (MPR) between double cleavage-stage embryo transfers compared to single and double blastocysts stage embryo transfers in a single academic medical centre. Materials and Methods: This was a retrospective cohort study performed at the KK Women’s and Children’s Hospital In Vitro Fertilisation (KKIVF) Centre of all women who underwent fresh-cycle in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycles over a 5-year period. The outcome measures were CPR, LBR and MPR. The study included 5294 cycles, of which 539 patients underwent single embryo transfer (SET); 4533 patients underwent double embryo transfer (DET); 84 patients underwent double blastocyst transfer (DBT); and 65 patients underwent single blastocyst transfer (SBT). Results: The mean age of patients undergoing single blastocysts stage embryo transfer was lower than the other 2 groups. The DET, single and double blastocysts stage embryo transfer groups achieved similar LBR (33.9%, 38.7%, 35.4%, P >0.05) and CPR (42.4%, 46.2%, 46.9%). Conclusion: We found that single blastocysts stage embryo transfer is associated with similar LBR and CPR compared to double blastocysts stage embryo transfer and DET, with lower MPRs, and should be offered as standard practice, where possible. Key words: Infertility, Pregnancy outcomes

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Section: Resultsmentioning

confidence: 99%

Comparison between Single and Double Cleavage-Stage Embryo Transfers, Single and Double Blastocyst Transfers in a South East Asian In Vitro Fertilisation Centre

Kwek

Saffari

Tan

et al. 2018

Ann Acad Med Singap

Self Cite

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“…Moreover, we used the Kaplan-Meier survival analysis to estimate the crude PR, which might overestimate the cumulative PR. [ 26 ] The number of patients was limited; therefore, our study could only evaluate the optimal time to propose IVF treatment after surgery in patients with EFI scores ≥5. The purpose of the EFI classification is to provide valid clinical information on the PR over time after surgery.…”

Section: Discussionmentioning

confidence: 99%

Endometriosis Fertility Index for Predicting Pregnancy after Endometriosis Surgery

Zeng

Zhou

et al. 2017

Chin Med J

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Background:The endometriosis fertility index (EFI) has a predictive value for pregnancy after surgery. In vitro fertilization and embryo transfer (IVF-ET) is a good treatment to infertility. This study aimed to provide external validation of EFI, assess the factors affecting the ability of EFI to predict cumulative spontaneous pregnancy rates (PRs), and propose reasonable advice for treatment by evaluating the effect of infertility management combining surgery and IVF-ET.Methods:This retrospective study enrolled 345 endometriosis-related infertile women after laparoscopic surgery from January 2012 to January 2016. Among them, 234 patients tried to conceive naturally and were divided into six groups according to their different EFI scores. Of the 345 patients, 307 with an EFI score ≥5 were divided into non-IVF-ET group (n = 209) and IVE-ET group (n = 98) to compare the cumulative PRs. Cumulative PRs’ curves were calculated using the Kaplan-Meier product limit estimate and the differences were evaluated by log-rank test. Independent predictive factors for pregnancy were assessed using the Cox regression model.Results:Significant differences in spontaneous PRs among different EFI scores were identified (χ2 = 29.945, P < 0.05). The least function score was proved to be the most important factor for EFI (χ2 = 6.931, P < 0.05) staging system. In patients with an EFI score ≥5 after 12 months from surgery, the cumulative PRs of those who received both surgery and IVF-ET were much higher than the spontaneous PRs of those who received surgery alone (χ2 = 4.160, P = 0.041).Conclusions:The EFI is a reliable staging system to predict the spontaneous PR of patients. The least function score was the most influential factor to predict the spontaneous PR. Patients with an EFI score ≥5 after 12 months from surgery are recommended to receive IVF-ET to achieve a higher PR.

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“…We use a fixed dropout rate of 50%. In Germany, dropout rates between 40% and 50% are reported . For sensitivity analysis, we range the dropout rate between 30% and 70%.…”

Section: Methodsmentioning

confidence: 99%

“…In Germany, dropout rates between 40% and 50% are reported. 17,18 For sensitivity analysis, we range the dropout rate between 30% and 70%. To disregard general trends in the number of patients, we calculate market shares m:…”

Section: Stadhouders Et Al E1313mentioning

confidence: 99%

Do quality improvements in assisted reproduction technology increase patient numbers in a managed competition setting?

Stadhouders¹,

Kremer²,

Jeurissen³

et al. 2019

Health Planning & Management

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Summary In a system of managed competition, selective contracting and patient choice reward providers for quality improvements through increases in patient numbers and revenue. We research whether these mechanisms function as envisioned by investigating the relationship between quality improvements and patient numbers in assisted reproduction technology in the Netherlands. Success rate improvements primarily reduce volume as fewer secondary treatments are necessary, but this can be compensated by attracting new patients. Using nationwide registry data from 1996 to 2016, we find limited evidence that high‐quality clinics attract new patients, and insufficiently as to compensate for the reduction in secondary treatments. The net effect of quality increases appears to be a small decline in revenue. Therefore, we conclude that patient choice and active purchasing reward quality improvements insufficiently. Nevertheless, clinics have improved quality drastically over the last years, showing that financial incentives are perhaps less important factors for quality improvements than factors such as intrinsic motivation and professional autonomy.

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Estimating cumulative live-birth rates after IVF treatment with Kaplan–Meier and competing risk methods

Cited by 8 publications

References 39 publications

Comparison between Single and Double Cleavage-Stage Embryo Transfers, Single and Double Blastocyst Transfers in a South East Asian In Vitro Fertilisation Centre

Comparison between Single and Double Cleavage-Stage Embryo Transfers, Single and Double Blastocyst Transfers in a South East Asian In Vitro Fertilisation Centre

Endometriosis Fertility Index for Predicting Pregnancy after Endometriosis Surgery

Do quality improvements in assisted reproduction technology increase patient numbers in a managed competition setting?

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