Repeated implantation failure at the crossroad between statistics, clinics and over-diagnosis
Articolo
Data di Pubblicazione:
2017
Citazione:
Repeated implantation failure at the crossroad between statistics, clinics and over-diagnosis / E. Somigliana, P. Vigano, A. Busnelli, A. Paffoni, W. Vegetti, P. Vercellini. - In: REPRODUCTIVE BIOMEDICINE ONLINE. - ISSN 1472-6483. - (2017 Oct 12). [Epub ahead of print] [10.1016/j.rbmo.2017.09.012]
Abstract:
The most common definition of repeated implantation failure (RIF) is the failure to obtain a clinical
pregnancy after three completed IVF cycles. This definition, however, may lead to misuse of the
diagnosis. To disentangle this, we set up a mathematical model based on the following main
assumptions: rate of success of IVF constant and set at 30%; and RIF postulated to be a
dichotomous condition (yes or no) with a prevalence of 10%. On this basis, the expected cumulative
chance of pregnancy after three and six cycles was 59% and 79%, respectively. Consequently, the
false–positive rate of a diagnosis of RIF is 75% and 51%, respectively. Increasing the rate of
success of IVF or the prevalence of RIF lowers but does not make unremarkable the rate of false–
positive diagnoses. Overall, this model shows that the commonly used definition of RIF based on
three failed attempts in a standard population with good prognosis leads to over-diagnosis and,
potentially, to over-treatments.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
false positive; IVF; model; repeated implantation failure
Elenco autori:
E. Somigliana, P. Vigano, A. Busnelli, A. Paffoni, W. Vegetti, P. Vercellini
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