Human Reproduction, Vol. 8, No. 9, pp. 1361-1366, 1993
© 1993 European Society of Human Reproduction and Embryology
research-article |
Endocrinology: The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. II. Multiple discriminant analysis for risk prediction
1Hôpital Universitaire Saint Pierre Brussels 2Centre Hospitalier Régional de la Citadelle Liège 3Academisch Ziekenhuis, Brussel Brussels 4Cliniques Universitaires Saint Luc Brussels 5Universitair Ziekenhuis Leuven 6Universitair Ziekenhuis Gent 7Hôpital Universitaire Erasme Brussels 8Universitair Ziekenhuis Antwerpen 9Clinique Saint Vincent Rocourt 10Medical Centre for Fertility Diagnostics Leuven 11Clinique Sainte Elisabeth Brussels 12Algemeen Ziekenhuis Middelheim Antwerpen 13Van Helmont Ziekenhuis Vilvoorde, Belgium
Correspondence: 14To whom correspondence should be addressed: IVF Clinic, Saint Pierre Hospital, Free University of Brussels, Rue Haute 322, B-1000 Brussels, Belgium
The considerable overlap of distributions of values for different parameters between control and ovarian hyperstimulation syndrome (OHSS) populations makes any single variable inefficient for risk prediction. Combinations of variables were studied in a discriminant function in order to increase predictivity and decrease the false negative rate. Such analyses were performed on two groups of in-vitro fertilization (IVF) patients: all OHSS cases (n = 128) (group A) and only severe OHSS cases (n = 92) (group B). Progressive introduction and automated stepwise selection of variables were applied to both groups. The best prediction (78.5%) was obtained in group A under post-oocyte retrieval conditions using log oestradiol, slope of log oestradiol increment, human menopausal gonadotrophin (HMG) dosage, number of oocytes retrieved and ratio of luteinizing hormone/follicle stimulating hormone (LH/FSH), in the formula. The corresponding false negative rate was 18.1%. However, effective prevention of OHSS implies the ability to withhold human chorionic gonadotrophin injection. Therefore a formula for pre-oocyte retrieval conditions was established yielding a prediction rate of 76.1% with a false negative rate of 18.1%. To be validated, such formulae have to be applied to another population of IVF cases used as a ‘testing-set’.
Key words: discriminant analysis/in-vitro fertilization/learning set/ovarian hyperstimulation syndrome/prediction
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