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Human Reproduction, Vol. 17, No. 1, 103-106, January 2002
© 2002 European Society of Human Reproduction and Embryology

Multivariate Markov chain analysis of the probability of pregnancy in infertile couples undergoing assisted reproduction

Joseph McDonnell1,3, Angelique J. Goverde2, Frans F.H. Rutten1 and Jan P.W. Vermeiden2

1 Institute for Medical Technology Assessment, Erasmus University, Rotterdam and 2 Division of Reproductive Endocrinology and Fertility, Institute for Endocrinology, Reproduction and Metabolism, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands

BACKGROUND: Estimating the probability of pregnancy leading to delivery and the influence of clinical factors on that probability is of fundamental importance in the treatment counselling of infertile couples. A variety of statistical techniques have been used to analyse fertility data, many borrowed from survival analysis. METHODS AND RESULTS: We propose an alternative method of analysis which is based on a discrete time Markov chain approach, with states ‘pregnancy (leading to a delivery)’, ‘not pregnant’, and ‘censored’ and in which the transition probabilities are dependent both on the clinical characteristics of the patient and the treatment given. CONCLUSIONS: We believe that the method of analysis presented here may be preferable to standard analyses in that it better reflects the clinical situation, it is a truly discrete time analysis applied to a discrete time situation, it explicitly models the censoring process (a process which in itself provides information of interest to the physician) and can be readily extended to a variety of clinical situations.

Key words: Markov chain/pregnancy data/statistical analysis

3 To whom correspondence should be addressed at: Institute for Medical Technology Assessment, Erasmus University, PO Box 1730, 3000 DR Rotterdam, The Netherlands. E-mail: mcdonnell{at}bmg.eur.nl


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