Custers Inge M, Steures Pieternel, van der Steeg Jan Willem, van Dessel Thierry J H M, Bernardus Rob E, Bourdrez Petra, Koks Carolien A M, Riedijk Wernard J, Burggraaff Jan M, van der Veen Fulco, Mol Ben W J
Center for Reproductive Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Fertil Steril. 2007 Aug;88(2):425-31. doi: 10.1016/j.fertnstert.2006.12.007. Epub 2007 Apr 3.
To assess the accuracy of our recently developed prediction model in a prospective validation study to predict the outcome of intrauterine insemination (IUI).
Descriptive prospective validation study.
Seven fertility centers in the Netherlands.
PATIENT(S): Couples treated with IUI of whom the female partner had a regular cycle.
INTERVENTION(S): Intrauterine insemination with or without controlled ovarian hyperstimulation.
MAIN OUTCOME MEASURE(S): Ongoing pregnancy after intrauterine insemination. Performance of the prediction model was assessed with calibration and discriminative capacity. Calibration was assessed by comparing the predicted ongoing pregnancy rate with the observed ongoing pregnancy rate. Discriminative capacity was assessed with receiver operation characteristic (ROC) analysis. For daily practice, a score worksheet of the validated model was developed to estimate the chance of an ongoing pregnancy after IUI per treatment cycle.
RESULT(S): We included 1,079 subfertile couples who underwent 4,244 cycles of IUI. There were 278 ongoing pregnancies, that is, an ongoing pregnancy rate of 6.6% per cycle. External validation of the model showed good calibration. The predicted probability never differed by more than 1.5% of the mean observed probability. The area under the ROC curve was 0.56 (95% confidence interval, 0.53-0.59) at external validation.
CONCLUSION(S): The prediction model was able to make a good distinction between couples with a good pregnancy chance and those with a poor pregnancy chance after IUI. This model can help in deciding which couples will benefit from IUI and which couples will not.
在一项前瞻性验证研究中评估我们最近开发的预测模型预测宫腔内人工授精（IUI）结局的准确性。
描述性前瞻性验证研究。
荷兰的七个生育中心。
接受IUI治疗且女性伴侣月经周期规律的夫妇。
有或没有控制性卵巢过度刺激的宫腔内人工授精。
宫腔内人工授精后的持续妊娠情况。通过校准和区分能力评估预测模型的性能。通过比较预测的持续妊娠率和观察到的持续妊娠率来评估校准情况。通过受试者操作特征（ROC）分析评估区分能力。为日常临床实践，开发了经过验证的模型的评分工作表，以估计每个治疗周期IUI后持续妊娠的几率。
我们纳入了1079对不育夫妇，他们接受了4244个周期的IUI。有278例持续妊娠，即每个周期的持续妊娠率为6.6%。该模型的外部验证显示校准良好。预测概率与平均观察概率的差异从未超过1.5%。外部验证时ROC曲线下面积为0.56（95%置信区间，0.53 - 0.59）。
该预测模型能够很好地区分IUI后妊娠几率高的夫妇和妊娠几率低的夫妇。该模型有助于决定哪些夫妇将从IUI中获益，哪些夫妇不会。
