Prediction of an ongoing pregnancy after intrauterine insemination

Steures P, Pieternel Steures, Van Der Steeg JW, Jan Willem van der Steeg, Ben W. Mol, Ben W J Mol, Mol BW, Eijkemans MJ, Marinus J C Eijkemans, van der Veen F, Fulco van der Veen, J. Dik F. Habbema, Habbema JD, Peter G A Hompes, Hompes PG, Patrick M. Bossuyt, Bossuyt PM, Patrick M M Bossuyt, Verhoeve HR, Harold R Verhoeve, van Kasteren YM, Y.M. van Kasteren, Yvonne M van Kasteren, van Dop PA, P. A. van Dop, Peter A van Dop, CECERM (Collaborative Effort in Clinical Evaluation in Reproductive Medicine)
Fertility and sterility · 2004 · vol. 82(1) , pp. 45–51 · doi:10.1016/j.fertnstert.2003.12.028 · PMID:15236988 · W2155017708
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This study investigated factors predicting successful ongoing pregnancy following intrauterine insemination procedures.

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Abstract

ObjectiveTo develop a prognostic model for the outcome of IUI.DesignRetrospective cohort study.SettingFour fertility centers in The Netherlands.Patient(s)Couples of whom the female partners had a regular cycle and who had been treated with IUI.Intervention(s)Intrauterine insemination with and without ovarian hyperstimulation.Main outcome measure(s)Ongoing pregnancy.Result(s)Overall, 3371 couples were included who underwent 14968 cycles. There were 1229 (8.2%) pregnancies, of which 1000 (6.7%) pregnancies were ongoing. Logistic regression analysis demonstrated that increasing maternal age, longer duration of subfertility, presence of male factor subfertility, one-sided tubal pathology, endometriosis, uterine anomalies, and an increasing number of cycles were unfavorable predictors for an ongoing pregnancy. Cervical factor and the use of ovarian hyperstimulation were favorable predictors. The area under the receiver operating characteristic curve was 0.59. When couples were divided into four categories based on prognosis, the difference between the predicted and observed chance, that is, the calibration, was less than 0.5% in each of the four groups.Conclusion(s)Although our model had a relatively poor discriminative capacity, data on calibration showed that the selected prognostic factors allow distinction between couples with a poor prognosis and couples with a good prognosis. After external validation, this model could be of use in patient counseling and clinical decision making.

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MeSH descriptors

Infertility Insemination, Artificial Models, Biological Pregnancy Prognosis Adult Cohort Studies Female Humans Infertility Infertility Logistic Models Male Multivariate Analysis Retrospective Studies ROC Curve

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