Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins
Identifieur interne : 001114 ( Istex/Corpus ); précédent : 001113; suivant : 001115Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins
Auteurs : A. Nyboe Andersen ; A. H. Balen ; P. Platteau ; G. Pettersson ; J.-C. ArceSource :
- Human Reproduction [ 0268-1161 ] ; 2010-08.
Abstract
BACKGROUND The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle. METHODS Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol. RESULTS The univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth. CONCLUSIONS The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.
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DOI: 10.1093/humrep/deq142
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title><author><name sortKey="Nyboe Andersen, A" sort="Nyboe Andersen, A" uniqKey="Nyboe Andersen A" first="A." last="Nyboe Andersen">A. Nyboe Andersen</name><affiliation><mods:affiliation>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anders.nyboe.andersen@rh.regionh.dk</mods:affiliation></affiliation></author><author><name sortKey="Balen, A H" sort="Balen, A H" uniqKey="Balen A" first="A. H." last="Balen">A. H. Balen</name><affiliation><mods:affiliation>Department of Obstetrics & Gynaecology, Leeds General Infirmary, Leeds, UK</mods:affiliation></affiliation></author><author><name sortKey="Platteau, P" sort="Platteau, P" uniqKey="Platteau P" first="P." last="Platteau">P. Platteau</name><affiliation><mods:affiliation>UZ Brussel, Centre for Reproductive Medicine, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Pettersson, G" sort="Pettersson, G" uniqKey="Pettersson G" first="G." last="Pettersson">G. Pettersson</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</mods:affiliation></affiliation></author><author><name sortKey="Arce, J C" sort="Arce, J C" uniqKey="Arce J" first="J.-C." last="Arce">J.-C. Arce</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1093/humrep/deq142</idno><idno type="url">https://api.istex.fr/document/CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001114</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title><author><name sortKey="Nyboe Andersen, A" sort="Nyboe Andersen, A" uniqKey="Nyboe Andersen A" first="A." last="Nyboe Andersen">A. Nyboe Andersen</name><affiliation><mods:affiliation>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anders.nyboe.andersen@rh.regionh.dk</mods:affiliation></affiliation></author><author><name sortKey="Balen, A H" sort="Balen, A H" uniqKey="Balen A" first="A. H." last="Balen">A. H. Balen</name><affiliation><mods:affiliation>Department of Obstetrics & Gynaecology, Leeds General Infirmary, Leeds, UK</mods:affiliation></affiliation></author><author><name sortKey="Platteau, P" sort="Platteau, P" uniqKey="Platteau P" first="P." last="Platteau">P. Platteau</name><affiliation><mods:affiliation>UZ Brussel, Centre for Reproductive Medicine, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Pettersson, G" sort="Pettersson, G" uniqKey="Pettersson G" first="G." last="Pettersson">G. Pettersson</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</mods:affiliation></affiliation></author><author><name sortKey="Arce, J C" sort="Arce, J C" uniqKey="Arce J" first="J.-C." last="Arce">J.-C. Arce</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Human Reproduction</title><idno type="ISSN">0268-1161</idno><idno type="eISSN">1460-2350</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-08">2010-08</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1988">1988</biblScope><biblScope unit="page" to="1995">1995</biblScope></imprint><idno type="ISSN">0268-1161</idno></series><idno type="istex">CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8</idno><idno type="DOI">10.1093/humrep/deq142</idno><idno type="ArticleID">deq142</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0268-1161</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">BACKGROUND The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle. METHODS Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol. RESULTS The univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth. CONCLUSIONS The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>A. Nyboe Andersen</name><affiliations><json:string>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark</json:string><json:string>E-mail: anders.nyboe.andersen@rh.regionh.dk</json:string></affiliations></json:item><json:item><name>A.H. Balen</name><affiliations><json:string>Department of Obstetrics & Gynaecology, Leeds General Infirmary, Leeds, UK</json:string></affiliations></json:item><json:item><name>P. Platteau</name><affiliations><json:string>UZ Brussel, Centre for Reproductive Medicine, Brussels, Belgium</json:string></affiliations></json:item><json:item><name>G. Pettersson</name><affiliations><json:string>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</json:string></affiliations></json:item><json:item><name>J.-C. Arce</name><affiliations><json:string>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>anovulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>gonadotrophin</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>live birth</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>nomogram</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>prediction model</value></json:item></subject><articleId><json:string>deq142</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>BACKGROUND The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle. METHODS Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol. RESULTS The univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth. CONCLUSIONS The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.</abstract><qualityIndicators><score>8.323</score><pdfVersion>1.5</pdfVersion><pdfPageSize>612.283 x 790.866 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1794</abstractCharCount><pdfWordCount>4323</pdfWordCount><pdfCharCount>28979</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>260</abstractWordCount></qualityIndicators><title>Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title><genre><json:string>research-article</json:string></genre><host><volume>25</volume><publisherId><json:string>humrep</json:string></publisherId><pages><last>1995</last><first>1988</first></pages><issn><json:string>0268-1161</json:string></issn><issue>8</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1460-2350</json:string></eissn><title>Human Reproduction</title></host><categories><wos><json:string>OBSTETRICS & GYNECOLOGY</json:string><json:string>REPRODUCTIVE BIOLOGY</json:string></wos></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1093/humrep/deq142</json:string></doi><id>CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8</id><score>0.23751307</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.</p></availability><date>2010-06-03</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title><author xml:id="author-1"><persName><forename type="first">A.</forename><surname>Nyboe Andersen</surname></persName><email>anders.nyboe.andersen@rh.regionh.dk</email><affiliation>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark</affiliation></author><author xml:id="author-2"><persName><forename type="first">A.H.</forename><surname>Balen</surname></persName><affiliation>Department of Obstetrics & Gynaecology, Leeds General Infirmary, Leeds, UK</affiliation></author><author xml:id="author-3"><persName><forename type="first">P.</forename><surname>Platteau</surname></persName><affiliation>UZ Brussel, Centre for Reproductive Medicine, Brussels, Belgium</affiliation></author><author xml:id="author-4"><persName><forename type="first">G.</forename><surname>Pettersson</surname></persName><affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</affiliation></author><author xml:id="author-5"><persName><forename type="first">J.-C.</forename><surname>Arce</surname></persName><affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</affiliation></author></analytic><monogr><title level="j">Human Reproduction</title><idno type="pISSN">0268-1161</idno><idno type="eISSN">1460-2350</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-08"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1988">1988</biblScope><biblScope unit="page" to="1995">1995</biblScope></imprint></monogr><idno type="istex">CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8</idno><idno type="DOI">10.1093/humrep/deq142</idno><idno type="ArticleID">deq142</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010-06-03</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>BACKGROUND The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle. METHODS Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol. RESULTS The univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth. CONCLUSIONS The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>anovulation</term></item><item><term>gonadotrophin</term></item><item><term>live birth</term></item><item><term>nomogram</term></item><item><term>prediction model</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-06-03">Created</change><change when="2010-08">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="publisher-id">humrep</journal-id><journal-id journal-id-type="hwp">humrep</journal-id><journal-title>Human Reproduction</journal-title><issn pub-type="ppub">0268-1161</issn><issn pub-type="epub">1460-2350</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/humrep/deq142</article-id><article-id pub-id-type="publisher-id">deq142</article-id><article-categories><subj-group subj-group-type="heading"><subject>ORIGINAL ARTICLES</subject><subj-group subj-group-type="heading"><subject>Infertility</subject></subj-group></subj-group></article-categories><title-group><article-title>Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nyboe Andersen</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Balen</surname><given-names>A.H.</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Platteau</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Pettersson</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Arce</surname><given-names>J.-C.</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib></contrib-group><aff id="af1"><label>1</label><institution>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet</institution>, <addr-line>2100 Copenhagen</addr-line>, <country>Denmark</country></aff><aff id="af2"><label>2</label><addr-line>Department of Obstetrics & Gynaecology</addr-line>, <institution>Leeds General Infirmary</institution>, <addr-line>Leeds</addr-line>, <country>UK</country></aff><aff id="af3"><label>3</label><institution>UZ Brussel, Centre for Reproductive Medicine</institution>, <addr-line>Brussels</addr-line>, <country>Belgium</country></aff><aff id="af4"><label>4</label><addr-line>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen</addr-line>, <country>Denmark</country></aff><author-notes><corresp id="cor1"><label>*</label>Correspondence address. E-mail: <email>anders.nyboe.andersen@rh.regionh.dk</email></corresp></author-notes><pub-date pub-type="ppub"><month>8</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>3</day><month>6</month><year>2010</year></pub-date><volume>25</volume><issue>8</issue><fpage>1988</fpage><lpage>1995</lpage><history><date date-type="received"><day>27</day><month>10</month><year>2009</year></date><date date-type="rev-recd"><day>8</day><month>3</month><year>2010</year></date><date date-type="accepted"><day>12</day><month>5</month><year>2010</year></date></history><permissions><copyright-statement>© The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.</copyright-statement><copyright-year>2010</copyright-year><license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by-nc/2.5/"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</p></license></permissions><abstract><sec><title>BACKGROUND</title><p>The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle.</p></sec><sec><title>METHODS</title><p>Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (<italic>n</italic> = 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol.</p></sec><sec><title>RESULTS</title><p>The univariate analysis identified age [OR = 0.91 (95% CI: 0.84–0.98), <italic>P</italic> = 0.015], duration of infertility [OR = 0.71 (95% CI: 0.56–0.91), <italic>P</italic> = 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR = 0.83 (95% CI: 0.69–0.99), <italic>P</italic> = 0.034] and menstrual cycle pattern (<italic>P</italic> = 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth.</p></sec><sec><title>CONCLUSIONS</title><p>The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.</p></sec></abstract><kwd-group><kwd>anovulation</kwd><kwd>gonadotrophin</kwd><kwd>live birth</kwd><kwd>nomogram</kwd><kwd>prediction model</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins</title></titleInfo><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Nyboe Andersen</namePart><affiliation>The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark</affiliation><affiliation>E-mail: anders.nyboe.andersen@rh.regionh.dk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.H.</namePart><namePart type="family">Balen</namePart><affiliation>Department of Obstetrics & Gynaecology, Leeds General Infirmary, Leeds, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P.</namePart><namePart type="family">Platteau</namePart><affiliation>UZ Brussel, Centre for Reproductive Medicine, Brussels, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G.</namePart><namePart type="family">Pettersson</namePart><affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.-C.</namePart><namePart type="family">Arce</namePart><affiliation>Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical & Non-Clinical R&D, Copenhagen, Denmark</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2010-08</dateIssued><dateCreated encoding="w3cdtf">2010-06-03</dateCreated><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>BACKGROUND The objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle. METHODS Univariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol. RESULTS The univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth. CONCLUSIONS The chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.</abstract><subject><genre>keywords</genre><topic>anovulation</topic><topic>gonadotrophin</topic><topic>live birth</topic><topic>nomogram</topic><topic>prediction model</topic></subject><relatedItem type="host"><titleInfo><title>Human Reproduction</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0268-1161</identifier><identifier type="eISSN">1460-2350</identifier><identifier type="PublisherID">humrep</identifier><identifier type="PublisherID-hwp">humrep</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>1988</start><end>1995</end></extent></part></relatedItem><identifier type="istex">CE2176ED3EE805DDF1B3B1E9AA0C790D0417EEE8</identifier><identifier type="DOI">10.1093/humrep/deq142</identifier><identifier type="ArticleID">deq142</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author 2010. 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