TY - JOUR
T1 - A revised prediction model for natural conception
AU - Bensdorp, Alexandra J.
AU - van der Steeg, Jan Willem
AU - Steures, Pieternel
AU - Habbema, J. Dik F.
AU - Hompes, P. G.A.
AU - Bossuyt, Patrick M.M.
AU - van der Veen, Fulco
AU - Mol, Ben W.J.
AU - Eijkemans, Marinus J.C.
AU - on behalf of CECERM study group
PY - 2017/6/1
Y1 - 2017/6/1
N2 - One of the aims in reproductive medicine is to differentiate between couples that have favourable chances of conceiving naturally and those that do not. Since the development of the prediction model of Hunault, characteristics of the subfertile population have changed. The objective of this analysis was to assess whether additional predictors can refine the Hunault model and extend its applicability. Consecutive subfertile couples with unexplained and mild male subfertility presenting in fertility clinics were asked to participate in a prospective cohort study. We constructed a multivariable prediction model with the predictors from the Hunault model and new potential predictors. The primary outcome, natural conception leading to an ongoing pregnancy, was observed in 1053 women of the 5184 included couples (20%). All predictors of the Hunault model were selected into the revised model plus an additional seven (woman's body mass index, cycle length, basal FSH levels, tubal status,history of previous pregnancies in the current relationship (ongoing pregnancies after natural conception, fertility treatment or miscarriages), semen volume, and semen morphology. Predictions from the revised model seem to concur better with observed pregnancy rates compared with the Hunault model; c-statistic of 0.71 (95% CI 0.69 to 0.73) compared with 0.59 (95% CI 0.57 to 0.61).
AB - One of the aims in reproductive medicine is to differentiate between couples that have favourable chances of conceiving naturally and those that do not. Since the development of the prediction model of Hunault, characteristics of the subfertile population have changed. The objective of this analysis was to assess whether additional predictors can refine the Hunault model and extend its applicability. Consecutive subfertile couples with unexplained and mild male subfertility presenting in fertility clinics were asked to participate in a prospective cohort study. We constructed a multivariable prediction model with the predictors from the Hunault model and new potential predictors. The primary outcome, natural conception leading to an ongoing pregnancy, was observed in 1053 women of the 5184 included couples (20%). All predictors of the Hunault model were selected into the revised model plus an additional seven (woman's body mass index, cycle length, basal FSH levels, tubal status,history of previous pregnancies in the current relationship (ongoing pregnancies after natural conception, fertility treatment or miscarriages), semen volume, and semen morphology. Predictions from the revised model seem to concur better with observed pregnancy rates compared with the Hunault model; c-statistic of 0.71 (95% CI 0.69 to 0.73) compared with 0.59 (95% CI 0.57 to 0.61).
KW - Natural conception
KW - Prediction model
KW - Prognosis
KW - Subfertility
UR - http://www.scopus.com/inward/record.url?scp=85018638231&partnerID=8YFLogxK
U2 - 10.1016/j.rbmo.2017.03.014
DO - 10.1016/j.rbmo.2017.03.014
M3 - Article
C2 - 28434653
AN - SCOPUS:85018638231
VL - 34
SP - 619
EP - 626
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
SN - 1472-6483
IS - 6
ER -