Use of a prediction model for high-order multiple implantation after ovarian stimulation with gonadotropins

Abstract

Objective: To determine prospectively the effectiveness in clinical practice of a prediction model for high-order multiple pregnancies (HOMP) (triplets or more).

Design: Prospective study.

Setting: University teaching hospital.

Patient(s): Eight hundred forty-nine consecutive infertile patients undergoing a total of 1,542 treatment cycles.

Intervention(s): Gonadotropin ovarian stimulation or induction of ovulation without IVF MAIN OUTCOME MEASURE(S): Observed and predicted overall pregnancy rates and the incidence of HOMP.

Result(s): The use of the prediction model (implying cancellation of all cycles at high risk for HOMP) would result in an 8% (95% confidence interval, 6.8%-9.2%) reduction of overall pregnancy rate but also in a 285% (95% CI, 279%-291%) reduction of HOMP.

Conclusion(s): By using our prediction model, it was possible to maintain a low risk of HOMP with a good pregnancy rate in patients receiving gonadotropin ovarian stimulation or induction of ovulation without IVF.