To what extent does anti-mullerian hormone contribute to a better prediction of live birth after IVF?
Identifieur interne : 001F57 ( Ncbi/Merge ); précédent : 001F56; suivant : 001F58To what extent does anti-mullerian hormone contribute to a better prediction of live birth after IVF?
Auteurs : Catherine Rongieres [France] ; Carolina Colella [France] ; Philippe Lehert [Belgique, Australie]Source :
- Journal of Assisted Reproduction and Genetics [ 1058-0468 ] ; 2014.
Abstract
We assessed the predictive value added by Anti-Mullerian Hormone (AMH) to currently validated live birth (LB) prediction models.
Based on recent data from our center, we compared the external validity of the Templeton Model (TM) and its recent improvement (TMA) to select our model of reference. The added predictive value of AMH was assessed in testing the likelihood ratio significance and the Net Reclassification Index (NRI). The surrogate utility of AMH was tested by conducting an exploratory stepwise logistic regression.
Based on 715 cycles, the original TM had poor performances (auROC C = 0.61 [0.58, 0.66], improving by fitting TM to our data (C = 0.71[0.66, 0.75]. TMA fitting proved better (C = 0.76; 95 %CI: 0.71, 0.80) and was selected as model of reference. Adding AMH to TMA or TM had no effect on discrimination (C = 0.76; 95 %CI: 0.72, 0.80), the likelihood ratio test was significant (
The added predictive value of AMH is limited. A possible surrogate/simplifying effect of AMH was found in eliminating 9/13 predictors from the model of reference. We conclude that whereas AMH does not add significant predictive value to the existing model, it contributes to simplifying the equation to reliable, easy to collect, and available in all databases predictors: age, AMH, time trend and female previous fertility history.
Url:
DOI: 10.1007/s10815-014-0348-3
PubMed: 25370179
PubMed Central: 4294874
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>We assessed the predictive value added by Anti-Mullerian Hormone (AMH) to currently validated live birth (LB) prediction models.</p>
</sec>
<sec><title>Methods</title>
<p>Based on recent data from our center, we compared the external validity of the Templeton Model (TM) and its recent improvement (TMA) to select our model of reference. The added predictive value of AMH was assessed in testing the likelihood ratio significance and the Net Reclassification Index (NRI). The surrogate utility of AMH was tested by conducting an exploratory stepwise logistic regression.</p>
</sec>
<sec><title>Results</title>
<p>Based on 715 cycles, the original TM had poor performances (auROC C = 0.61 [0.58, 0.66], improving by fitting TM to our data (C = 0.71[0.66, 0.75]. TMA fitting proved better (C = 0.76; 95 %CI: 0.71, 0.80) and was selected as model of reference. Adding AMH to TMA or TM had no effect on discrimination (C = 0.76; 95 %CI: 0.72, 0.80), the likelihood ratio test was significant (<italic>p</italic>
= 0.023), but the NRI was not (6.7 %; <italic>p</italic>
= 0.055). A stepwise exploratory logistic regression identified the effects of age, previous IVF resulting in LB, time trend and AMH, leading to a prediction model reduced to four predictors (C = 0.75 [0.70, 0.81]).</p>
</sec>
<sec><title>Conclusion</title>
<p>The added predictive value of AMH is limited. A possible surrogate/simplifying effect of AMH was found in eliminating 9/13 predictors from the model of reference. We conclude that whereas AMH does not add significant predictive value to the existing model, it contributes to simplifying the equation to reliable, easy to collect, and available in all databases predictors: age, AMH, time trend and female previous fertility history.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Assist Reprod Genet</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Assist. Reprod. Genet</journal-id>
<journal-title-group><journal-title>Journal of Assisted Reproduction and Genetics</journal-title>
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<issn pub-type="ppub">1058-0468</issn>
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<contrib-group><contrib contrib-type="author"><name><surname>Rongieres</surname>
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<contrib contrib-type="author"><name><surname>Colella</surname>
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<contrib contrib-type="author" corresp="yes"><name><surname>Lehert</surname>
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ART Centre, Strasbourg, France</aff>
<aff id="Aff2"><label></label>
Faculty of Economics, UCL Mons, Louvain, Belgium</aff>
<aff id="Aff3"><label></label>
Faculty of Medicine, The University of Melbourne, Melbourne, Australia</aff>
<aff id="Aff4"><label></label>
Merck-Serono, Lyon, France</aff>
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<permissions><copyright-statement>© Springer Science+Business Media New York 2014</copyright-statement>
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<abstract id="Abs1"><sec><title>Objective</title>
<p>We assessed the predictive value added by Anti-Mullerian Hormone (AMH) to currently validated live birth (LB) prediction models.</p>
</sec>
<sec><title>Methods</title>
<p>Based on recent data from our center, we compared the external validity of the Templeton Model (TM) and its recent improvement (TMA) to select our model of reference. The added predictive value of AMH was assessed in testing the likelihood ratio significance and the Net Reclassification Index (NRI). The surrogate utility of AMH was tested by conducting an exploratory stepwise logistic regression.</p>
</sec>
<sec><title>Results</title>
<p>Based on 715 cycles, the original TM had poor performances (auROC C = 0.61 [0.58, 0.66], improving by fitting TM to our data (C = 0.71[0.66, 0.75]. TMA fitting proved better (C = 0.76; 95 %CI: 0.71, 0.80) and was selected as model of reference. Adding AMH to TMA or TM had no effect on discrimination (C = 0.76; 95 %CI: 0.72, 0.80), the likelihood ratio test was significant (<italic>p</italic>
= 0.023), but the NRI was not (6.7 %; <italic>p</italic>
= 0.055). A stepwise exploratory logistic regression identified the effects of age, previous IVF resulting in LB, time trend and AMH, leading to a prediction model reduced to four predictors (C = 0.75 [0.70, 0.81]).</p>
</sec>
<sec><title>Conclusion</title>
<p>The added predictive value of AMH is limited. A possible surrogate/simplifying effect of AMH was found in eliminating 9/13 predictors from the model of reference. We conclude that whereas AMH does not add significant predictive value to the existing model, it contributes to simplifying the equation to reliable, easy to collect, and available in all databases predictors: age, AMH, time trend and female previous fertility history.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>IVF</kwd>
<kwd>Prediction model</kwd>
<kwd>Templeton model</kwd>
<kwd>AMH</kwd>
<kwd>Live Birth</kwd>
</kwd-group>
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<meta-value>© Springer Science+Business Media New York 2015</meta-value>
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