Reducing multiples: A mathematical formula that accurately predicts rates of singletons, twins, and higher-order multiples in women undergoing in vitro fertilization

Zev Williams, Eric Banks, Mario Bkassiny, Sudharman K. Jayaweera, Rony Elias, Lucinda Veeck, Zev Rosenwaks

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To develop a mathematical formula that accurately predicts the probability of a singleton, twin, and higher-order multiple pregnancy according to implantation rate and number of embryos transferred. Design: A total of 12,003 IVF cycles from a single center resulting in ET were analyzed. Using mathematical modeling we developed a formula, the Combined Formula, and tested for the ability of this formula to accurately predict outcomes. Setting: Academic hospital. Patient(s): Patients undergoing IVF. Intervention(s): None. Main Outcome Measure(s): Goodness of fit of data from our center and previously published data to the Combined Formula and three previous mathematical models. Result(s): The Combined Formula predicted the probability of singleton, twin, and higher-order pregnancies more accurately than three previous formulas (1.4% vs. 2.88%, 4.02%, and 5%, respectively) and accurately predicted outcomes from five previously published studies from other centers. An online applet is provided (https://secure.ivf.org/ivf-calculator.html). Conclusion(s): The probability of pregnancy with singletons, twins, and higher-order multiples according to number of embryos transferred is predictable and not random and can be accurately modeled using the Combined Formula. The embryo itself is the major predictor of pregnancy outcomes, but there is an influence from "barriers," such as the endometrium and collaboration between embryos (embryo-embryo interaction). This model can be used to guide the decision regarding number of embryos to transfer after IVF.

Original languageEnglish (US)
Pages (from-to)1474-1480.e2
JournalFertility and sterility
Volume98
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • In vitro fertilization
  • embryo transfer
  • mathematical modeling
  • multiples
  • outcome predictors

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Reducing multiples: A mathematical formula that accurately predicts rates of singletons, twins, and higher-order multiples in women undergoing in vitro fertilization'. Together they form a unique fingerprint.

Cite this