Obstet Gynecol Sci.  2018 Nov;61(6):669-674. 10.5468/ogs.2018.61.6.669.

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

• Kim SK
• Kim H
• Oh S
• Lee JR
• Jee BC
• Kim SH

• KMID: 2426010
• DOI: http://doi.org/10.5468/ogs.2018.61.6.669

Abstract

OBJECTIVE
This study aimed to develop a nomogram that predicts ongoing pregnancy after in vitro fertilization and embryo transfer (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 human chorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoing pregnancy.
RESULTS
Patient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoing pregnancy. 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 was constructed using these three parameters, the addition of serum progesterone level to the prediction model did not increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG and progesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. The AUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age and serum 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 nomogram could help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ≥5 IU/L at 14 days post-OPU.

Keyword

Nomograms; Human chorionic gonadotropin; Progesterone; Pregnancy; In vitro fertilization

MeSH Terms

Area Under Curve
Chorionic Gonadotropin
Embryo Transfer*
Embryonic Structures*
Fertilization in Vitro*
Humans
In Vitro Techniques*
Nomograms*
Pregnancy*
Progesterone
Retrospective Studies
Chorionic Gonadotropin
Progesterone

Figure

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  Fig. 1 Linear regression relation between serum human chorionic gonadotropin and progesterone levels. HCG, human chorionic gonadotropin.

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  Fig. 2 Nomogram for patient age and serum human chorionic gonadotropin level at 14 days post–oocyte pick-up to predict ongoing pregnancy after in vitro fertilization and embryo transfer treatment. HCG, human chorionic gonadotropin.

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