PMID- 21558332
OWN - NLM
STAT- MEDLINE
DCOM- 20111109
LR  - 20220409
IS  - 1460-2350 (Electronic)
IS  - 0268-1161 (Linking)
VI  - 26
IP  - 7
DP  - 2011 Jul
TI  - Association between the number of eggs and live birth in IVF treatment: an 
      analysis of 400 135 treatment cycles.
PG  - 1768-74
LID - 10.1093/humrep/der106 [doi]
AB  - BACKGROUND: While live birth is the principal clinical outcome following in vitro 
      fertilization (IVF) treatment, the number of eggs retrieved following ovarian 
      stimulation is often used as a surrogate outcome in clinical practice and 
      research. The aim of this study was to explore the association between egg number 
      and live birth following IVF treatment and identify the number of eggs that would 
      optimize the IVF outcome. METHODS: Anonymized data on all IVF cycles performed in 
      the UK from April 1991 to June 2008 were obtained from the Human Fertilization 
      and Embryology Authority (HFEA). We analysed data from 400 135 IVF cycles. A 
      logistic model was fitted to predict live birth using fractional polynomials to 
      handle the number of eggs as a continuous independent variable. The prediction 
      model, which was validated on a separate HFEA data set, allowed the estimation of 
      the probability of live birth for a given number of eggs, stratified by age 
      group. We produced a nomogram to predict the live birth rate (LBR) following IVF 
      based on the number of eggs and the age of the female. RESULTS: The median number 
      of eggs retrieved per cycle was 9 [inter-quartile range (IQR) 6-13]. The overall 
      LBR was 21.3% per fresh IVF cycle. There was a strong association between the 
      number of eggs and LBR; LBR rose with an increasing number of eggs up to  approximately 15, 
      plateaued between 15 and 20 eggs and steadily declined beyond 20 eggs. During 
      2006-2007, the predicted LBR for women with 15 eggs retrieved in age groups 
      18-34, 35-37, 38-39 and 40 years and over was 40, 36, 27 and 16%, respectively. 
      There was a steady increase in the LBR per egg retrieved over time since 1991. 
      CONCLUSION: The relationship between the number of eggs and live birth, across 
      all female age groups, suggests that the number of eggs in IVF is a robust 
      surrogate outcome for clinical success. The results showed a non-linear 
      relationship between the number of eggs and LBR following IVF treatment. The 
      number of eggs to maximize the LBR is  approximately 15.
FAU - Sunkara, Sesh Kamal
AU  - Sunkara SK
AD  - Guy's and St Thomas' Foundation Trust, King's College London, London, UK.
FAU - Rittenberg, Vivian
AU  - Rittenberg V
FAU - Raine-Fenning, Nick
AU  - Raine-Fenning N
FAU - Bhattacharya, Siladitya
AU  - Bhattacharya S
FAU - Zamora, Javier
AU  - Zamora J
FAU - Coomarasamy, Arri
AU  - Coomarasamy A
LA  - eng
PT  - Journal Article
PT  - Validation Study
DEP - 20110510
PL  - England
TA  - Hum Reprod
JT  - Human reproduction (Oxford, England)
JID - 8701199
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Birth Rate
MH  - Female
MH  - *Fertilization in Vitro
MH  - Humans
MH  - *Live Birth
MH  - Logistic Models
MH  - Oocyte Retrieval
MH  - Ovulation Induction
MH  - Ovum/*physiology
MH  - Pregnancy
EDAT- 2011/05/12 06:00
MHDA- 2011/11/10 06:00
CRDT- 2011/05/12 06:00
PHST- 2011/05/12 06:00 [entrez]
PHST- 2011/05/12 06:00 [pubmed]
PHST- 2011/11/10 06:00 [medline]
AID - der106 [pii]
AID - 10.1093/humrep/der106 [doi]
PST - ppublish
SO  - Hum Reprod. 2011 Jul;26(7):1768-74. doi: 10.1093/humrep/der106. Epub 2011 May 10.