Hughes E G, King C, Wood E C
Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Richmond, Australia.
Fertil Steril. 1989 May;51(5):838-44. doi: 10.1016/s0015-0282(16)60676-3.
Multiple factors influence the outcome of in vitro fertilization and embryo transfer (IVF-ET). This prospective study was designed to assess their relative importance, in order to improve prognostic ability and treatment success. Prior to IVF-ET, couples were divided into "good" (GP) and "poor" (PP) prognosis groups according to female age, semen quality, previous response to stimulation, and embryo quality. The data obtained from 716 consecutive treatment cycles then were evaluated using univariate statistics and logistic regression, a technique designed to assess the relative contribution of significant factors. The pregnancy rate per GP cycle was 14.7%, compared with 5.4% per PP cycle (chi 1(2) = 12.7, P less than 0.001). The most important prognostic factors were female age, the pregnancy rate showing a linear decline after the age of 25, and previous failed fertilization due to abnormal sperm. The rate of pregnancy also declined after 14 or more follicles were aspirated and/or nine oocytes were retrieved. A formula for the probability of pregnancy, derived from the logistic regression, provides patients with a more accurate prognosis before treatment.
多种因素影响体外受精与胚胎移植（IVF-ET）的结果。本前瞻性研究旨在评估这些因素的相对重要性，以提高预后判断能力和治疗成功率。在进行IVF-ET之前，根据女性年龄、精液质量、既往刺激反应及胚胎质量，将夫妇分为“良好”（GP）和“不良”（PP）预后组。随后，使用单变量统计和逻辑回归对从716个连续治疗周期中获得的数据进行评估，逻辑回归是一种用于评估重要因素相对贡献的技术。每个GP周期的妊娠率为14.7%，而每个PP周期为5.4%（卡方值1(2)=12.7，P<0.001）。最重要的预后因素是女性年龄，25岁之后妊娠率呈线性下降，以及既往因精子异常导致受精失败。在抽吸14个或更多卵泡和/或获取9个卵母细胞后，妊娠率也会下降。从逻辑回归得出的妊娠概率公式，能在治疗前为患者提供更准确的预后判断。
