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A clinical counseling tool predicting supernumerary embryos after a fresh IVF cycle

  • Assisted Reproduction Technologies
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Abstract

Purpose

To identify factors predictive of having supernumerary embryos in a fresh IVF cycle and create a prediction model for clinical counseling.

Methods

We utilized a multivariable Poisson regression to identify predictive factors and then entered these into a logistic regression model, calculating a risk index for each significant variable. The final model was tested using a receiver operating characteristic curve.

Results

A total of 60,616 fresh transfer cycles were reported to the Society for Assisted Reproductive Technology in 2014. Of these, 47.17% produced supernumerary embryos. A multivariate Poisson regression identified factors predictive of having supernumerary embryos, with age and AMH being the most predictive. Clinical prediction models were developed with acceptable and excellent discrimination. 23.5% of our cohort did not achieve a live birth following their fresh transfer and had excess embryos cryopreserved for future attempts.

Conclusion

Our study suggests that in a minority of fresh IVF cycles in the USA, the fresh transfer is not successful, and there are excess embryos cryopreserved for future use. The likelihood of excess embryos beyond those that would be transferred can be predicted with satisfactory precision prior to initiation of the cycle and with improved precision after fresh embryo transfer. Providing patients with a realistic estimate of their chances of having excess embryos at an initial IVF consult especially those with suspected poor prognosis can be beneficial in determining whether to proceed with multiple embryo banking cycles as opposed to proceeding with a fresh transfer, and whether to opt for an enhanced embryo selection technique such as preimplantation genetic testing for aneuploidy (PGT-A).

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Acknowledgments

SART wishes to thank all of its members for providing clinical information to the SART CORS database for use by patients and researchers. Without the efforts of our members, this research would not have been possible.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, School of Medicine, 675 Arapeen Drive, Suite 205, Salt Lake City, UT, 84108, USA

    Yetunde Ibrahim & Erica Johnstone

  2. Division of Epidemiology, Study Design and Biostatistics Center, University of Utah Health Center for Clinical and Translational Science, 295 Chipeta Way, Salt Lake City, UT, 84122, USA

    Greg Stoddard

Authors
  1. Yetunde Ibrahim
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  2. Greg Stoddard
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  3. Erica Johnstone
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Correspondence to Yetunde Ibrahim.

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Ibrahim, Y., Stoddard, G. & Johnstone, E. A clinical counseling tool predicting supernumerary embryos after a fresh IVF cycle. J Assist Reprod Genet 37, 1137–1145 (2020). https://doi.org/10.1007/s10815-020-01731-8

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  • DOI: https://doi.org/10.1007/s10815-020-01731-8

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