Predicting ongoing pregnancy chances after IVF and ICSI: a national prospective study

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Subfertility Research

Background:

• Current Dutch IVF guidelines use patient triage based on diagnostic category, infertility duration, and female age.
• Evidence supporting the effectiveness of these specific triage criteria is lacking.
• This study aimed to evaluate the predictive value of these characteristics and develop a predictive model for IVF pregnancy chances.

Purpose of the Study:

• To assess the predictive value of patient characteristics used in the Dutch IVF guideline.
• To develop a model for predicting the chance of ongoing pregnancy after IVF/ICSI within 12 months.
• To identify key predictors of IVF/ICSI success.

Main Methods:

• A national prospective cohort study involving 4928 couples undergoing IVF or ICSI.
• Data collected from 11 IVF centers and 20 transport IVF clinics.
• Kaplan-Meier analysis and Cox regression were used to estimate pregnancy probabilities and analyze predictor effects.

Main Results:

• The 1-year ongoing pregnancy rate was 44.8% for IVF/ICSI treatments.
• Intracytoplasmic sperm injection (ICSI) for severe oligospermia showed higher success rates than IVF.
• Women's age was a significant predictor, with a sharp decline in success rates after age 35. Primary subfertility and duration of subfertility also impacted pregnancy chances.

Conclusions:

• Women's age and the use of ICSI are the most significant predictors of IVF/ICSI pregnancy success.
• Diagnostic category does not influence pregnancy chance.
• Duration of subfertility and pregnancy history have limited prognostic value.