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Development of a novel nomogram for predicting ongoing pregnancy after in vitro fertilization and embryo transfer

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주제분류산부인과학

초록

Objective This study aimed to develop a nomogram that predicts ongoing pregnancy after in vitro fertilization and embryotransfer (IVF-ET) using patient age and serum hormonal markers. Methods A total of 284 IVF-ET cycles were retrospectively analyzed. At 14 days post-oocyte pick-up (OPU), the serum humanchorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoingpregnancy. Results Patient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoingpregnancy. The cut-off value and area under the curve (AUC) (95% confidence interval) were 36.5 years and 0.666(0.599–0.733), respectively, for patient age; 67.8 mIU/mL and 0.969 (0.951–0.987), respectively, for serum HCG level;and 29.8 ng/mL and 0.883 (0.840–0.925), respectively, for serum progesterone level. When the prediction model wasconstructed using these three parameters, the addition of serum progesterone level to the prediction model didnot increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG andprogesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. TheAUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age andserum HCG level was as high as 0.975. Conclusion We showed that ongoing pregnancy may be predicted using only patient age and HCG serum level. Our nomogramcould help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ≥5 IU/L at 14 dayspost-OPU.

Abstract

Objective This study aimed to develop a nomogram that predicts ongoing pregnancy after in vitro fertilization and embryotransfer (IVF-ET) using patient age and serum hormonal markers. Methods A total of 284 IVF-ET cycles were retrospectively analyzed. At 14 days post-oocyte pick-up (OPU), the serum humanchorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoingpregnancy. Results Patient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoingpregnancy. The cut-off value and area under the curve (AUC) (95% confidence interval) were 36.5 years and 0.666(0.599–0.733), respectively, for patient age; 67.8 mIU/mL and 0.969 (0.951–0.987), respectively, for serum HCG level;and 29.8 ng/mL and 0.883 (0.840–0.925), respectively, for serum progesterone level. When the prediction model wasconstructed using these three parameters, the addition of serum progesterone level to the prediction model didnot increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG andprogesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. TheAUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age andserum HCG level was as high as 0.975. Conclusion We showed that ongoing pregnancy may be predicted using only patient age and HCG serum level. Our nomogramcould help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ≥5 IU/L at 14 dayspost-OPU.

참고문헌 (10)

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  3. Wang Q, "Serum human chorionic gonadotropin measured 7 days following day 3 embryo transfer might predict pregnancy outcome in IVF", Gynecol Endocrinol, 33, pp.62~66 (2017)
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  7. Kim JH, "Nomogram to predict ongoing pregnancy using age of women and serum biomarkers after in vitro fertilization cycles", Eur J Obstet Gynecol Reprod Biol, 172, pp.65~69 (2014)
  8. Tulchinsky D, "Plasma human chorionic gonadotropin, estrone, estradiol, estriol, progesterone, and 17α-hydroxyprogesterone in human pregnancy. 3. Early normal pregnancy", Am J Obstet Gynecol, 117, pp.884~893 (1973)
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