Joint Modeling of In Vitro Fertilization outcomes among Infertile Couples

Document Type : Original Article


1 Safety Promotion and Injury Prevention research center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical sciences, Tehran, Iran.

2 Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

4 Department of Biostatistics, School of public health, IRAN University of Medical Sciences, Tehran, Iran.

5 Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR Tehran, Iran.



Background: Women who undergo in vitro fertilization (IVF) cycles should successfully go via multiple stages (i.e., clinical pregnancy, no abortion under 12 weeks, no abortion under 20 weeks, and delivery) to achieve live births. In this study, data from multiple cycles and multiple stages during the IVF cycle are gathered for each woman to model the impacts of factors associated with success at various stages of IVF cycles in Iranian infertile women based on the purpose of the study.

Materials and Methods: This historical cohort study includes 3676 assisted reproductive technology (ART) cycles in infertile couples. Covariates take into account in this study were women’s age, type of infertility (primary, secondary), BMI, cause of infertility, history of abortion, duration of infertility, number of oocyte, number of embryo, fertilization rate, factors of sperm(Spermogram) and having polycystic ovarian syndrome (PCO) during IVF cycles. Joint modeling was fitted to apply informative cluster size.

Results: Women’s age, history of abortion, having PCO and BMI had positive relation with number of cycles, and Spermogram had negative relation with that. Cycle number had negative relation with success of IVF, but number of oocytes, fertilization rate and Spermogram had positive relation with success of IVF.

Conclusion: Using a joint model of the number of cycles and the result of IVF is a better model because usually the number of cycles that is significant is ignored.

Keywords: Cluster Analysis, Infertile couples, In Vitro Fertilization


Main Subjects