Modelization of fecundability stepped recently from demography and population-based contexts to reproductive biology and treatment of infertility. This created a strong call for flexibility and robustness. Indeed, explained and unexplained heterogeneities are non-negligible sources of bias that result in false conclusions as to the determinants of fertility or to the success rates of reproductive techniques, among other examples. There are two main sources of heterogeneity: biological heterogeneity and heterogeneity of sexual behaviour. A uniform presentation of time-to-pregnancy and Barrett-Marshall models is proposed to enlighten their similarities and differences in modelling heterogeneity of fecundability. Mixed models for fecundability studies are presented as tools to allow for unexplained heterogeneity and to quantify heterogeneity of the effect of observed factors and variability of size of this unexplained heterogeneity between subpopulations. Some criteria for the modelling strategy in fecundability studies are suggested with emphasis on the unit-treatment additivity criterion. The strong and complex selection process resulting from heterogeneity is described as well as the selection and cross-selection processes of observed and unobserved fecundability factors. Consequences regarding data collection and statistical inference are discussed. In the current context, a consensus setting general rules for data collection and statistical analysis would be useful to compare the results and increase the reliability of these results in medical practice.

译文

:可生育能力的建模近来已从人口统计学和基于人口的环境发展到生殖生物学和不育症的治疗。这强烈要求灵活性和鲁棒性。的确,解释性和无法解释的异质性是造成偏差的不可忽略的原因,在其他例子中,它们导致关于生育率的决定因素或生殖技术成功率的错误结论。异质性有两个主要来源:生物学异质性和性行为异质性。提出了妊娠时间模型和Barrett-Marshall模型的统一表示,以启发它们在生育力异质性建模方面的异同。提出了用于可生育性研究的混合模型,作为允许无法解释的异质性和量化观察因素影响的异质性以及子种群之间这种无法解释的异质性的大小变异性的工具。建议在可生育性研究中建立模型策略的一些标准,重点放在单位处理可加性标准上。描述了异质性导致的强大而复杂的选择过程,以及观察到的和未观察到的生育力因子的选择和交叉选择过程。讨论了有关数据收集和统计推断的后果。在当前情况下,为数据收集和统计分析设定通用规则的共识将有助于比较结果并提高这些结果在医学实践中的可靠性。

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