Random Effect Models in the Statistical Analysis of Human Fecundability Data: Application to artificial insemination with sperm from donor.

Ecochard, Rene (1997). Random Effect Models in the Statistical Analysis of Human Fecundability Data: Application to artificial insemination with sperm from donor. PhD thesis The Open University.

Abstract

The main aim of this dissertation is to explore methodological approaches to correlated binary data and to assess their suitability for the analysis of data on human fertility. The dataset concerns a study of Artificial Insemination by Donor (AID). AID represents an unusual research opportunity to study both male and female fecundability simultaneously. In each attempt to conceive, artificial insemination is carried out in consecutive ovulatory cycles until conception or change of treatment. The probability of conception may differ between women, so that the data are discrete time survival data with censoring and between-subject heterogeneity. There is also potential heterogeneity between donors. Non-systematic allocation of the donor to recipient ensures that the same woman receives semen from several donors, This added heterogeneity as well as other cycle dependent covariates have to be taken into account. The analysis must also take account of covariates, most of them time-varying. Our dataset have a crossed hierarchical structure due to the presence of both, female and male factors. The rather complicated "design" calls for unit specific regression models. These models are presented as well as their lack of tractability except in some rather specific cases. The motivation for choosing Gaussian random effects in unit specific regression models is discussed. We demonstrate the use of an approximate inference method (Penalized Quasi Likelihood). This method is shown to be a useful and practical way of carrying out preliminary data analysis. Finally a Bayesian procedure (Gibbs sampling) provides validation and more accurate results despite the intensive computation it needs.

The main substantive finding of the analysis is the unexpectedly pronounced heterogeneity of donor fecundability, even after inclusion of conventional measures of sperm quality into the model. These measures were shown to be predictive at the donor level but not at the level of individual donation.

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