Predicting IVF outcome

On 25 July 1978 at 11.47 PM Louise Brown was born as the first IVF baby ever. Since its introduction more than 5 million babies have been born worldwide using IVF. In contrast to patients’ perception, IVF does not guarantee success; almost 50% of couples that start with IVF will not achieve a pregnancy through IVF even if they undergo multiple cycles. Given this limited success, it seems logical to offer IVF only to couples with reasonable chances of success and to discontinue treatment when chances are low and do not outweigh the burden and costs associated with treatment. As doctors are not able to correctly predict these pregnancy chances, prediction models can be a useful tool.
Another concern in current IVF practice is the high multiple pregnancy rates as multiple pregnancies are associated with an increase in maternal and perinatal morbidity and mortality as well as costs. A more individualized embryo transfer strategy could be a solution.
This PhD thesis describes the development and validation of several prediction models in IVF. The first part of this thesis focuses on couples’ prognosis with IVF. The second part of this thesis focuses on optimizing embryo transfer strategies.