Kupka Markus S, Dorn Christoph, Richter Oliver, Felberbaum Ricardo, van der Ven Hans
Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Fertil Steril. 2003 Sep;80(3):508-16. doi: 10.1016/s0015-0282(03)00760-x.
To evaluate the effect of reproductive history on the outcome of different procedures in assisted reproductive technologies (ART) comparing IVF, ICSI, and cryopreserved embryo transfer (CPE).
Prospective registration of ART cycles and their outcomes.
One hundred three reproductive programs in Germany.
PATIENT(S): Women undergoing 174,909 ART procedures from January 1998 through December 2000.
INTERVENTION(S): Data analysis of reproductive history collected by the German IVF Registry; multiple logistic regression modeling of success rates.
MAIN OUTCOME MEASURE(S): Effect of type of conception and outcome of previous pregnancies, duration of infertility, female's age, and type of ART on clinical pregnancy rate per retrieval. Odds ratios with 95% CIs are reported.
RESULT(S): More than one previous pregnancy was negatively correlated with outcome of IVF, ICSI, or CPE. This association disappeared when female age was restricted to a maximum of 35 years. A previous pregnancy achieved by spontaneous conception had less impact on outcome of IVF, ICSI or CPE outcome than did a previous assisted conception. Previous live births and miscarriages demonstrated a statistically significant increase compared with ectopic pregnancies and induced abortions.
CONCLUSION(S): Reproductive history must be considered when counseling subfertile couples. Female age, method of conception, and previous pregnancy outcome have a significant effect on IVF, ICSI, and CPE outcome.
比较体外受精（IVF）、卵胞浆内单精子注射（ICSI）和冷冻胚胎移植（CPE），评估生殖史对辅助生殖技术（ART）中不同程序结局的影响。
ART周期及其结局的前瞻性登记。
德国的103个生殖项目。
1998年1月至2000年12月接受174,909例ART程序的女性。
对德国体外受精登记处收集的生殖史进行数据分析；成功率的多因素逻辑回归建模。
受孕类型和既往妊娠结局、不孕持续时间、女性年龄以及ART类型对每次取卵临床妊娠率的影响。报告95%置信区间的比值比。
既往有不止一次妊娠与IVF、ICSI或CPE的结局呈负相关。当女性年龄限制在最大35岁时，这种关联消失。与既往辅助受孕相比，既往自然受孕对IVF、ICSI或CPE结局的影响较小。与异位妊娠和人工流产相比，既往活产和流产在统计学上有显著增加。
在为不育夫妇提供咨询时必须考虑生殖史。女性年龄、受孕方式和既往妊娠结局对IVF、ICSI和CPE结局有显著影响。
