High singleton live birth rate confirmed following ovulation induction in women with anovulatory polycystic ovary syndrome: Validation of a prediction model for clinical practice
Classical ovulation induction is an effective therapy for women with polycystic ovary syndrome. Women with a poor treatment prognosis can be identified according to age, duration of infertility, and body mass index.
Susanne M.Veltman-Verhulst, M.D., Bart C.J.M. Fauser, M.D., Ph.D., Marinus J.C. Eijkemans, M.Sc., Ph.D.
Volume 98, Issue 3, Pages 761-768.e1, September 2012
To evaluate the cumulative singleton live birth rate following classical ovulation induction in women with anovulatory Polycystic Ovary Syndrome (PCOS) and to validate a previously developed prediction model.
Prospective follow-up study.
Tertiary Infertility Unit, University Medical Center Utrecht, the Netherlands.
Validation cohort of 108 treatment naïve anovulatory PCOS patients.
Conventional ovulation induction, applying clomiphene citrate as first line treatment followed by exogenous gonadotropins as second line intervention.
Main Outcome Measures:
Singleton live birth prediction. Model calibration and discrimination were assessed for the initial model (variables included: age, duration of infertility and insulin/glucose ratio) and a second model in which the insulin/glucose ratio was replaced by Body Mass Index (BMI).
The cumulative singleton live birth rate after 12 and 24 months was 60% and 78%, respectively. Overall, the observed rates were higher than predicted; hazard ratio of 1.21 (95% CI 0.89-1.64), 1st model and 1.25 (95% CI 1.20-1.30), 2nd model. However, the predictive capacity of the model variables was reliable with calibration slopes of 0.79 (95% CI -0.04-1.63) and 1.06 (95% CI 0.95–1.18), respectively.
The current study confirms the previously reported good treatment prognosis for women with PCOS undergoing classical ovulation induction. Women with a poor prognosis – where alternative treatment options may be considered – can best be identified by a prediction model including age, duration of infertility and BMI.
Clinical trial registration number: