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As a subgraph of the learned BN structure, a compact set of influential factors for return are extracted which jointly have high influence on the rate of return and low mutual redundancy among themselves.
Objective To develop a prediction model to estimate the chances of a live birth over multiple complete cycles of in vitro fertilisation (IVF) based on a couple’s specific characteristics and treatment information. Participants All 253 417 women who started IVF (including intracytoplasmic sperm injection) treatment in the UK from 1999 to 2008 using their own eggs and partner’s sperm.Women who had no eggs collected were excluded from the post-treatment model because it would not be possible to achieve a live birth in the first complete cycle.Therefore we fitted a separate model for these women.In this population based cohort study, records of all complete IVF and ICSI cycles—defined as all attempts at fresh and frozen embryo transfer resulting from one episode of ovarian stimulation—in women who started their first ovarian stimulation in the UK between January 1999 and September 2008 were extracted up until September 2009 when exposure to IVF ended.Data from October 2009 onwards were not included in the analysis because consent for patient data on IVF or ICSI to be used in research changed from “presumed” to “required” at that point.Supplementary figure A1 details further exclusion criteria made on receipt of the data.
Baseline characteristics of couples included the woman’s age, duration of infertility (years), type of infertility (categorised as diagnosis of tubal, endometriosis, anovulation, male factor, or unexplained), previous pregnancy status of the couple (yes versus no), treatment type (ICSI versus IVF), and year of first egg retrieval.
This novel resource may help couples plan their treatment and prepare emotionally and financially for their IVF journey.
In the United Kingdom, one in six couples experience difficulties conceiving.1 In vitro fertilisation (IVF) is the recommended treatment of choice for all couples with continued unresolved fertility problems.2 By the end of 2013 over five million people were born as a result of IVF or intracytoplasmic sperm injection (ICSI).3Although the success of IVF and ICSI has conventionally been reported as the livebirth rate in a single fresh cycle,4 5 widespread use of embryo cryopreservation in the past two decades has meant that cumulative livebirth rates, which include frozen embryo replacements as well as subsequent treatment episodes, are more informative, as they empower couples and clinicians to make strategic decisions about care over a period of time.6 However, cumulative livebirth rates are often reported either as one overall average rate or stratified by the woman’s age or type of infertility at a national or IVF clinic level.7 8 9 10 11 Given that many other patient and treatment characteristics can affect the success of IVF or ICSI,12 it can be difficult for clinicians to counsel couples as to their individualised chances of success over a complete package of IVF or ICSI treatment.
An anonymised HFEA database is freely available online for research purposes.13 14 15 16 This version only contains data at the individual (fresh or frozen) IVF treatment level, with no link between treatment and individual women—a requirement when estimating the cumulative probability of a live birth.
However, a more detailed version of the HFEA database is available for research purposes under strict conditions, which links all IVF treatments to complete cycles and to individual women and allows estimation of the cumulative probability of a live birth.15 17 Following approval by the North of Scotland research ethics committee, the Confidentiality Advisory Group, and the HFEA register research panel, anonymised data on all treatments linked to each woman undergoing IVF or ICSI were made available to the authors.
Treatment level characteristics from the attempt at fresh embryo transfer of the first complete cycle included number of eggs collected, number of embryos transferred, stage of embryo transfer (cleavage versus blastocyst), and whether embryos were frozen (cryopreservation of embryos).