Development of a novel nomogram for predicting ongoing pregnancy after fertilization and embryo transfer

• Main Authors: Seul Ki Kim, Hyein Kim, Soohyun Oh, Jung Ryeol Lee, Byung Chul Jee, Seok Hyun Kim
• Format: Article
• Language: English
• Published: Korean Society of Obstetrics and Gynecology 2018-11-01
• Series: Obstetrics & Gynecology Science
• Subjects: nomograms; human chorionic gonadotropin; progesterone; pregnancy; fertilization
• Online Access: http://ogscience.org/upload/pdf/ogs-61-669.pdf
• ISSN: 2287-8572; 2287-8580

ObjectiveThis study aimed to develop a nomogram that predicts ongoing pregnancy after in vitro fertilization and embryo transfer (IVF-ET) using patient age and serum hormonal markers.MethodsA total of 284 IVF-ET cycles were retrospectively analyzed. At 14 days post-oocyte pick-up (OPU), the serum human chorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoing pregnancy.ResultsPatient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoing pregnancy. The cut-off value and area under the curve (AUC) (95% confidence interval) were 36.5 years and 0.666 (0.599–0.733), respectively, for patient age; 67.8 mIU/mL and 0.969 (0.951–0.987), respectively, for serum HCG level; and 29.8 ng/mL and 0.883 (0.840–0.925), respectively, for serum progesterone level. When the prediction model was constructed using these three parameters, the addition of serum progesterone level to the prediction model did not increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG and progesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. The AUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age and serum HCG level was as high as 0.975.ConclusionWe showed that ongoing pregnancy may be predicted using only patient age and HCG serum level. Our nomogram could help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ≥5 IU/L at 14 days post-OPU.