{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:47:19Z","timestamp":1788716839567,"version":"build-2803163510"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Elphinstone scholarship scheme at the University of Aberdeen and the Assisted Reproduction Unit at Aberdeen Fertility Centre"},{"DOI":"10.13039\/501100000882","name":"University of Aberdeen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000882","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"Abstract<\/jats:title>\n \n STUDY QUESTION<\/jats:title>\n Can we develop an IVF prediction model to estimate individualized chances of a live birth over multiple complete cycles of IVF in couples embarking on their second complete cycle of treatment?<\/jats:p>\n <\/jats:sec>\n \n SUMMARY ANSWER<\/jats:title>\n Yes, our prediction model can estimate individualized chances of cumulative live birth over three additional complete cycles of IVF.<\/jats:p>\n <\/jats:sec>\n \n WHAT IS KNOWN ALREADY<\/jats:title>\n After the completion of a first complete cycle of IVF, couples who are unsuccessful may choose to undergo further treatment to have their first child, while those who have had a live birth may decide to have more children. Existing prediction models can estimate the overall chances of success in couples before commencing IVF but are unable to revise these chances on the basis of the couple\u2019s response to a first treatment cycle in terms of the number of eggs retrieved and pregnancy outcome. This makes it difficult for couples to plan and prepare emotionally and financially for the next step in their treatment.<\/jats:p>\n <\/jats:sec>\n \n STUDY DESIGN, SIZE, DURATION<\/jats:title>\n For model development, a population-based cohort was used of 49\u200a314 women who started their second cycle of IVF including ICSI in the UK from 1999 to 2008 using their own oocytes and their partners\u2019 sperm. External validation was performed on data from 39\u200a442 women who underwent their second cycle from 2010 to 2016.<\/jats:p>\n <\/jats:sec>\n \n PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n Data about all UK IVF treatments were obtained from the Human Fertilisation and Embryology Authority (HFEA) database. Using a discrete time logistic regression model, we predicted the cumulative probability of live birth from the second up to and including the fourth complete cycles of IVF. Inverse probability weighting was used to account for treatment discontinuation. Discrimination was assessed using c-statistic and calibration was assessed using calibration-in-the-large and calibration slope.<\/jats:p>\n <\/jats:sec>\n \n MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n Following exclusions, 49\u200a314 women with 73\u200a053 complete cycles were included. 12\u200a408 (25.2%) had a live birth resulting from their second complete cycle. Cumulatively, 17\u200a394 (35.3%) had a live birth over complete cycles two to four. The model showed moderate discriminative ability (c-statistic: 0.65, 95% CI: 0.64 to 0.65) and evidence of overprediction (calibration-in-the-large\u2009=\u2009\u22120.08) and overfitting (calibration slope 0.85, 95% CI: 0.81 to 0.88) in the validation cohort. However, after recalibration the fit was much improved. The recalibrated model identified the following key predictors of live birth: female age (38 versus 32\u2009years\u2014adjusted odds ratio: 0.59, 95% CI: 0.57 to 0.62), number of eggs retrieved in the first complete cycle (12 versus 4 eggs; 1.34, 1.30 to 1.37) and outcome of the first complete cycle (live birth versus no pregnancy; 1.78, 1.66 to 1.91; live birth versus pregnancy loss; 1.29, 1.23 to 1.36). As an example, a 32-year-old with 2\u2009years of non-tubal infertility who had 12 eggs retrieved from her first stimulation and had a live birth during her first complete cycle has a 46% chance of having a further live birth from the second complete cycle of IVF and an 81% chance over a further three cycles.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n The developed model was updated using validation data that was 6 to 12\u2009years old. IVF practice continues to evolve over time, which may affect the accuracy of predictions from the model. We were unable to adjust for some potentially important predictors, e.g. BMI, smoking and alcohol intake in women, as well as measures of ovarian reserve such as antral follicle count. These were not available in the linked HFEA dataset.<\/jats:p>\n <\/jats:sec>\n \n WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n By appropriately adjusting for couples who discontinue treatment, our novel prediction model will provide more realistic chances of live birth in couples starting a second complete cycle of IVF. Clinicians can use these predictions to inform discussion with couples who wish to plan ahead. This prediction tool will enable couples to prepare emotionally, financially and logistically for IVF treatment.<\/jats:p>\n <\/jats:sec>\n \n STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n This study was supported by an Elphinstone scholarship scheme at the University of Aberdeen and Aberdeen Fertility Centre, University of Aberdeen. The authors have no conflict of interest.<\/jats:p>\n <\/jats:sec>\n \n TRIAL REGISTRATION NUMBER<\/jats:title>\n N\/A.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/humrep\/deac152","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T13:59:40Z","timestamp":1658498380000},"page":"2075-2086","source":"Crossref","is-referenced-by-count":15,"title":["Predicting cumulative live birth for couples beginning their second complete cycle of in vitro<\/i> fertilization treatment"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9468-6688","authenticated-orcid":false,"given":"Mariam B","family":"Ratna","sequence":"first","affiliation":[{"name":"Institute of Applied Health Sciences, University of Aberdeen , Aberdeen, UK"},{"name":"Warwick Clinical Trial Units, Warwick Medical School, University of Warwick , Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siladitya","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"School of Medicine, Medical Sciences & Nutrition, University of Aberdeen , Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"van Geloven","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences, Medical Statistics, Leiden University Medical Center , Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8905-2429","authenticated-orcid":false,"given":"David J","family":"McLernon","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Sciences, University of Aberdeen , Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"2022090106010450400_deac152-B1","first-page":"145","article-title":"Cumulative live birth rate and assisted reproduction: impact of female age and transfer day","volume":"6","author":"Abuzeid","year":"2014","journal-title":"Facts Views Vis Obgyn"},{"key":"2022090106010450400_deac152-B2","doi-asserted-by":"crossref","first-page":"3533","DOI":"10.1177\/0962280220932189","article-title":"Bootstrap inference for multiple imputation under uncongeniality and misspecification","volume":"29","author":"Bartlett","year":"2020","journal-title":"Stat Methods Med Res"},{"key":"2022090106010450400_deac152-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-14-1297","article-title":"Drinking pattern is more strongly associated with under-reporting of alcohol consumption than socio-demographic factors: evidence from a mixed-methods study","volume":"14","author":"Boniface","year":"2014","journal-title":"BMC Public Health"},{"key":"2022090106010450400_deac152-B4","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1093\/humrep\/dex293","article-title":"Cumulative live birth rates following miscarriage in an initial complete cycle of IVF: a retrospective cohort study of 112 549 women","volume":"32","author":"Cameron","year":"2017","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.cmpb.2003.10.004","article-title":"Adjusted survival curves with inverse probability weights","volume":"75","author":"Cole","year":"2004","journal-title":"Comput Methods Programs Biomed"},{"key":"2022090106010450400_deac152-B6","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/bjs.9736","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement","volume":"102","author":"Collins","year":"2015","journal-title":"Br J Surg"},{"key":"2022090106010450400_deac152-B7","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1093\/humrep\/dep109","article-title":"Evaluating prediction models in reproductive medicine","volume":"24","author":"Coppus","year":"2009","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B8","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1093\/biomet\/45.3-4.562","article-title":"Two further applications of a model for binary regression","volume":"45","author":"Cox","year":"1958","journal-title":"Biometrika"},{"key":"2022090106010450400_deac152-B9","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.fertnstert.2006.12.007","article-title":"External validation of a prediction model for an ongoing pregnancy after intrauterine insemination","volume":"88","author":"Custers","year":"2007","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B10","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1093\/humrep\/deh889","article-title":"Life table (survival) analysis to generate cumulative pregnancy rates in assisted reproduction: are we overestimating our success rates?","volume":"20","author":"Daya","year":"2005","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B11","volume-title":"Applied Missing Data Analysis","author":"Enders","year":"2010"},{"key":"2022090106010450400_deac152-B12","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/humupd\/dms031","article-title":"Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment","volume":"18","author":"Gameiro","year":"2012","journal-title":"Hum Reprod Update"},{"key":"2022090106010450400_deac152-B13","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1093\/oxfordjournals.aje.a117592","article-title":"A critical look at methods for handling missing covariates in epidemiologic regression analyses","volume":"142","author":"Greenland","year":"1995","journal-title":"Am J Epidemiol"},{"key":"2022090106010450400_deac152-B14","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/humrep\/deh303","article-title":"Towards less confusing terminology in reproductive medicine: a proposal","volume":"19","author":"Habbema","year":"2004","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"The meaning and use of the area under a receiver operating characteristic (ROC) curve","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"2022090106010450400_deac152-B16","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4","article-title":"Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors","volume":"15","author":"Harrell","year":"1996","journal-title":"Stat Med"},{"key":"2022090106010450400_deac152-B17","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","article-title":"structural approach to selection bias","volume":"15","author":"Hern\u00e1n","year":"2004","journal-title":"Epidemiology"},{"key":"2022090106010450400_deac152-B18","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1191\/0962280206sm439oa","article-title":"Estimating causal effects from multiple cycle data in studies of in vitro fertilization","volume":"15","author":"Hogan","year":"2006","journal-title":"Stat Methods Med Res"},{"key":"2022090106010450400_deac152-B19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1097\/EDE.0000000000000409","article-title":"Selection bias due to loss to follow up in cohort studies","volume":"27","author":"Howe","year":"2016","journal-title":"Epidemiology (Cambridge, Mass.)"},{"key":"2022090106010450400_deac152-B20","author":"Human Fertilisation and Embryology Authority","year":"2018"},{"key":"2022090106010450400_deac152-B21","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1093\/humrep\/13.6.1506","article-title":"Evidence that male smoking affects the likelihood of a pregnancy following IVF treatment: application of the modified cumulative embryo score","volume":"13","author":"Joesbury","year":"1998","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B22","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1093\/aje\/kwh258","article-title":"Updated risk factor values and the ability of the multivariable risk score to predict coronary heart disease","volume":"160","author":"Karp","year":"2004","journal-title":"Am J Epidemiol"},{"key":"2022090106010450400_deac152-B23","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.fertnstert.2014.05.020","article-title":"A prediction model for live birth and multiple births within the first three cycles of assisted reproductive technology","volume":"102","author":"Luke","year":"2014","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B24","first-page":"2703","article-title":"Cumulative live birth rate: time for a consensus?","volume":"30","author":"Maheshwari","year":"2015","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B25","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1093\/humrep\/dex096","article-title":"The long-term prognosis for live birth in couples initiating fertility treatments","volume":"32","author":"Malchau","year":"2017","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B26","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.fertnstert.2012.10.018","article-title":"The cumulative probability of liveborn multiples after in vitro fertilization: a cohort study of more than 10,000 women","volume":"99","author":"Malizia","year":"2013","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1056\/NEJMoa0803072","article-title":"Cumulative live-birth rates after in vitro fertilization","volume":"360","author":"Malizia","year":"2009","journal-title":"N Engl J Med"},{"key":"2022090106010450400_deac152-B28","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.fertnstert.2021.03.033","article-title":"Influence of paternal age on assisted reproductive technology cycles and perinatal outcomes","volume":"116","author":"Marsidi","year":"2021","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B29","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/humrep\/dev336","article-title":"Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178 898 women","volume":"31","author":"McLernon","year":"2016","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B30","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.fertnstert.2021.09.015","article-title":"Predicting personalized cumulative live birth following in vitro fertilization","volume":"117","author":"McLernon","year":"2022","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B31","doi-asserted-by":"crossref","first-page":"i5735","DOI":"10.1136\/bmj.i5735","article-title":"Predicting the chances of a live birth after one or more complete cycles of in vitro fertilisation: population based study of linked cycle data from 113 873 women","author":"McLernon","year":"2016","journal-title":"BMJ"},{"key":"2022090106010450400_deac152-B32","first-page":"CD002125","article-title":"Surgical treatment for tubal disease in women due to undergo in vitro fertilisation","volume":"10","author":"Melo","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2022090106010450400_deac152-B33","first-page":"2295","article-title":"IVF success corrected for drop-out: use of inverse probability weighting","volume":"33","author":"Modest","year":"2018","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B34","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1136\/heartjnl-2011-301247","article-title":"Risk prediction models: II. External validation, model updating, and impact assessment","volume":"98","author":"Moons","year":"2012","journal-title":"Heart"},{"key":"2022090106010450400_deac152-B35","author":"National Infertility Group Report","year":"2016"},{"key":"2022090106010450400_deac152-B36","author":"National Institute for Health and Care Excellence","year":"2018"},{"key":"2022090106010450400_deac152-B37","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1093\/humrep\/deaa030","article-title":"Cumulative live birth rates for women returning to ART treatment for a second ART-conceived child","volume":"35","author":"Paul","year":"2020","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B38","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1093\/humrep\/dez258","article-title":"A systematic review of the quality of clinical prediction models in in vitro fertilisation","volume":"35","author":"Ratna","year":"2020","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B39","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.fertnstert.2012.11.044","article-title":"Consecutive gonadotropin-releasing hormone-antagonist in vitro fertilization cycles: does the elapsed time interval between successive treatments affect outcomes?","volume":"99","author":"Reichman","year":"2013","journal-title":"Fertil Steril"},{"key":"2022090106010450400_deac152-B40","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/AOG.0b013e31820090e1","article-title":"Effect of alcohol consumption on in vitro fertilization","volume":"117","author":"Rossi","year":"2011","journal-title":"Obstet Gynecol"},{"key":"2022090106010450400_deac152-B41","volume-title":"Multiple Imputation for Nonresponse in Surveys","author":"Rubin","year":"2004"},{"key":"2022090106010450400_deac152-B42","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/GCO.0b013e3282fc9c1e","article-title":"Cigarette smoking and reproductive function","volume":"20","author":"Soares","year":"2008","journal-title":"Curr Opin Obstet Gynecol"},{"key":"2022090106010450400_deac152-B43","doi-asserted-by":"crossref","first-page":"b2393","DOI":"10.1136\/bmj.b2393","article-title":"Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls","volume":"338","author":"Sterne","year":"2009","journal-title":"BMJ"},{"key":"2022090106010450400_deac152-B44","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-16399-0","volume-title":"Clinical Prediction Models","author":"Steyerberg","year":"2019"},{"key":"2022090106010450400_deac152-B45","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.jclinepi.2008.04.008","article-title":"Validation, updating and impact of clinical prediction rules: a review","volume":"61","author":"Toll","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"2022090106010450400_deac152-B46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1466-7","article-title":"Calibration: the Achilles heel of predictive analytics","volume":"17","author":"Van Calster","year":"2019","journal-title":"BMC Med"},{"key":"2022090106010450400_deac152-B47","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/j.1471-0528.2006.00992.x","article-title":"Do clinical prediction models improve concordance of treatment decisions in reproductive medicine?","volume":"113","author":"Van Der Steeg","year":"2006","journal-title":"BJOG"},{"key":"2022090106010450400_deac152-B48","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1093\/humrep\/del378","article-title":"Pregnancy is predictable: a large-scale prospective external validation of the prediction of spontaneous pregnancy in subfertile couples","volume":"22","author":"Van Der Steeg","year":"2007","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B49","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/00223891.2018.1530680","article-title":"Rebutting existing misconceptions about multiple imputation as a method for handling missing data","volume":"102","author":"Van Ginkel","year":"2020","journal-title":"J Pers Assess"},{"key":"2022090106010450400_deac152-B50","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1093\/humupd\/dmq015","article-title":"Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis","volume":"16","author":"Van Loendersloot","year":"2010","journal-title":"Hum Reprod Update"},{"key":"2022090106010450400_deac152-B51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/850478","article-title":"Cumulative delivery rate after providing full reimbursement in vitro fertilization programme: a 6-years survey","volume":"2014","author":"Vrtacnik","year":"2014","journal-title":"Biomed Res Int"},{"key":"2022090106010450400_deac152-B52","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"2022090106010450400_deac152-B53","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1093\/humrep\/14.3.689","article-title":"How concordant are the estimated rates of natural conception and in-vitro fertilization\/embryo transfer success?","volume":"14","author":"Wiegerinck","year":"1999","journal-title":"Hum Reprod"},{"key":"2022090106010450400_deac152-B54","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1002\/sim.2174","article-title":"Adjusted Kaplan\u2013Meier estimator and log-rank test with inverse probability of treatment weighting for survival data","volume":"24","author":"Xie","year":"2005","journal-title":"Stat Med"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/37\/9\/2075\/45537131\/deac152.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/37\/9\/2075\/45537131\/deac152.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T06:11:58Z","timestamp":1662012718000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/37\/9\/2075\/6648434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":54,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,7,22]]},"published-print":{"date-parts":[[2022,8,25]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deac152","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,1]]},"published":{"date-parts":[[2022,7,22]]}}}