Modeling In Vitro Fertilization Data Considering Multiple Outcomes Observed among Iranian Infertile Women

Objective Women undergoing IVF cycles should go successfully through multiple points during the procedure (i.e., implantation, clinical pregnancy, no spontaneous abortion and delivery) to achieve live births. On the other there is a need to consider previous reproductive outcomes and as well as the current cycle. In this study, data on multiple cycles and multiple points during the IVF cycle are observed for each individual to model the factors associated with success in different stages during IVF cycles in Iranian infertile women. MaterialsAndMethods This historical cohort study includes 996 ART cycles of 511 infertile women. Covariates considered in this study were women’s age, type of cycle (fresh/frozen embryo transfer), number of embryos transferred and polycystic ovarian syndrome during IVF cycles. Generalized estimating equations was used for calculation of odds ratio (OR) and 95% confidence intervals (95% CI) of success in different stages during IVF cycles. Clustered-weighted GEE was also fitted to handle informative cluster size. Results After adjusting for potential confounders, receiving frozen embryo transfer was associated with higher odds of success compared to receiving fresh embryo transfer (adj OR, 2.26; 95% CI, 1.66-3.07); however, cycles with fresh embryo transfer did better in clinical pregnancy compared to those receiving frozen. Being in the age category of 38 to 40 was associated with lower odds of success compared to the reference category (