Multivariate analysis of factors predictive of successful live births in in vitro fertilization (IVF) suggests strategies to improve IVF outcome

D Minaretzis, D Harris, M M Alper, J F Mortola, M J Berger, D Power
Journal of assisted reproduction and genetics · 1998 · doi:10.1023/a:1022528915761 · PMID:9673880 · PMC3455016
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This study identified embryo quality and donor insemination as positively correlated with live births, while maternal age was negatively correlated, suggesting embryo transfer adjustments to improve IVF outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This paper analyzed clinical and embryology variables (maternal age; cause for IVF; donor insemination; attempt rank; day-of hCG serum estradiol and luteinizing hormone; flexible vs rigid catheter; and numbers/quality categories of embryos and cell counts) using logistic regression to identify predictors of pregnancy, live birth, and multiple births in an IVF setting. It found that endometriosis status and certain embryo characteristics (including 2-, 3-, and 4-cell “good” and “excellent” categories) were positively correlated with pregnancy and that specific embryo quality measures plus donor insemination were positively correlated with live births, while maternal age was negatively correlated with live births. The authors’ caveat is that the multivariate associations are tied to the variables modeled and the study design; the paper frames predictive “strategies” as model-based implications rather than a separately tested intervention. Relevance to endometriosis: endometriosis is explicitly reported as positively correlated with pregnancy outcomes in the multivariate analysis, though the paper’s main focus is identifying multivariate predictors of IVF success and their implications for outcomes.

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Abstract

PURPOSE: Our purpose was (1) to identify characteristics correlated with pregnancy outcome, (2) to use these characteristics to predict in vitro fertilization (IVF) outcome, and (3) to develop strategies that might improve IVF success. METHODS: Maternal age, cause for IVF, donor insemination, rank of attempt, serum estradiol and luteinizing hormone levels on the day of human chorionic gonadotropin administration, flexible vs rigid catheter, number of embryos transferred of each morphologic type, and cell number were analyzed by logistic regression. RESULTS: Variables positively correlated with success are as follows: (1) for pregnancy, endometriosis and 2-, 3-, and 4-cell good and 4-cell excellent embryos; (2) for live births, 2-, 3-, and 4-cell good and 4-cell excellent embryos and donor insemination; and (3) for multiple births, 2- and 4-cell good and 4-cell excellent embryos. Maternal age was negatively correlated with live births. CONCLUSIONS: Embryos derived from IVF have different potentials for implantation, live births, and multiple births. Transferring one additional good-quality embryo for each 5 years of incremental increase in maternal age is predicated to improve live birth rates without increasing multiple births.
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Abstract

Purpose: Our purpose was (1) to identify characteristics correlated with pregnancy outcome, (2) to use these characteristics to predict in vitro fertilization (IVF) outcome, and (3) to develop strategies that might improve IVF success.

Methods

Maternal age, cause for IVF, donor insemination, rank of attempt, serum estradiol and luteinizing hormone levels on the day of human chorionic gonadotropin administration, flexible vs rigid catheter, number of embryos transferred of each morphologic type, and cell number were analyzed by logistic regression.

Results

Variables positively correlated with success are as follows: (1) for pregnancy, endometriosis and 2-, 3-, and 4-cell good and 4-cell excellent embryos: (2) for live births, 2-, 3-, and 4-cell good and 4-cell excellent embryos and donor insemination; and (3) for multiple births, 2- and 4-cell good and 4-cell excellent embryos. Maternal age was negatively correlated with live births.

Conclusions

Embryos derived from IVF have different potentials for implantation, live births, and multiple births. Transferring one additional good-quality embryo for each 5 years of incremental increase in maternal age is predicated to improve live birth rates without increasing multiple births. Similar content being viewed by others

References

Edwards RG, Steptoe PC: Current status of in-vitro fertilization and implantation of human embryos. Lancet 1983;2:1265–1269 Hull MG, Eddowes HA, Fahy U, et al.: Expectations of assisted conception for infertility. BMJ 1992;304:1465–1469 FIVNAT (French in vitro National Registry) Analysis of 1986 to 1990 data. Fertil Steril 1993;59:587–595 Assisted reproductive technology in the United States and Canada: 1991 results from The Society for Assisted Reproductive Technology, The American Fertility Society Registry. Fertil Steril 1993;59:956–962 Hughes EG, King C, Wood EC: A prospective study of prognostic factors in in vitro fertilization and embryo transfer. Fertil Steril 1989;51:838–844 Puissant F, Van Rysselbergr M, Barlow P, Deweze J, Leroy F: Embryo scoring as a prognostic tool in IVF treatment. Hum Reprod 1987;2:705–708 Shulman A, Ben-Nun I, Ghetler Y, Kaneti H, Shilon M, Beyth Y: Relationship between embryo morhology and implantation rate after in vitro fertilization treatment in conception cycles. Fertil Steril 1993;60:123–126 Paulson RJ, Sauer MV, Lobo RA: Embryo implantation after human in vitro fertilization: importance of endometrial receptivity. Fertil Steril 1990;53:870–874 Dawson-Saunders B, Trapp RG (eds): Basic and Clinical Biostatistics. London, Prentice Hall Appleton and Lange, 1990 Abdalla HI, Burton G, Kirkland A, et al.: Age, pregnancy and misscarriage: Uterine versus ovarian factors. Hum Reprod 1993;8:1512–1517 Jansen RP: Spontaneous abortion incidence in the treatment of infertility. Am J Obstet Gynecol 1982;143:451–473 Groll M: Endometriosis and spontaneous abortion. Fertil Steril 1984;41: 933–935 Dicker D, Goldman JA, Levy T, Feldberg D, Ashkenazi J: The impact of long-term gonadotropin-releasing hormone analogue treatment on precrinical abortions in patients with severe endometriosis undergoing in vitro fertilization-embryo transfer. Fertil Steril 1982;57:597–600 Metzger DA, Olive DL, Stohs GF, Franklin RR: Association of endometriosis and spontaneous abortion: effect of control group selection. Fertil Steril 1986;45:18–22 Acosta AA, Moon SY, Oehninger S, Muasher SJ, Rosenwaks Z, Matta JF: Implantation potential of each pre-embryo in multiple pregnancies obtained by in vitro fertilization seems to be different. Fertil Steril 1988;50:906–911 Staessen C, Camus M, Bollen N, Devroey P, Van Steirteghem AC: The relationship between embryo quality and the occurance of multiple pregnancies. Fertil Steril 1992;57:626–630 Author information Authors and Affiliations Rights and permissions About this article Cite this article Minaretzis, D., Harris, D., Alper, M.M. et al. Multivariate Analysis of Factors Predictive of Successful Live Births in In Vitro Fertilization (IVF) Suggests Strategies to Improve IVF Outcome. J Assist Reprod Genet 15, 365–371 (1998). https://doi.org/10.1023/A:1022528915761 Issue date: DOI: https://doi.org/10.1023/A:1022528915761

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endometriosis

MeSH descriptors

Embryo Transfer Fertilization in Vitro Fertilization in Vitro Fertilization in Vitro Infertility, Female Infertility, Male Maternal Age Pregnancy Outcome Adult Analysis of Variance Embryo Transfer Embryo Transfer Estradiol Estradiol Female Humans Infertility, Female Infertility, Female Infertility, Male Likelihood Functions

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