Borges Edson, Zanetti Bianca Ferrarini, Braga Daniela Paes de Almeida Ferreira, Setti Amanda Souza, Figueira Rita Cássia Sávio, Iaconelli Assumpto
Fertility Medical Group, São Paulo, SP - Brazil.
Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida. São Paulo, SP - Brazil.
JBRA Assist Reprod. 2019 Apr 30;23(2):123-129. doi: 10.5935/1518-0557.20190001.
To study which factors affect perinatal outcomes in intracytoplasmic sperm injection (ICSI) cycles.
Data was obtained from 402 live births born to 307 patients undergoing ICSI cycles in a private university-affiliated IVF center between Jan/2014 and Dec/2015. The influences of the cycles' characteristics on the number of gestational weeks to livebirth (GW), baby birth weight (BW), and baby birth length (BL) were evaluated by linear regression models, adjusted for maternal age and body mass index, number of transferred embryos, number of gestational sacs, and number of born infants. In a subsequent analysis, GW, BW and baby sex were utilized for cycle classification into the groups Appropriate for gestational age (AGA n=256) and Small for gestational age (SGA n=146), which were compared by general linear models adjusted for the same confounder variables.
The number of follicles (β=-0.069 p=0.018) and retrieved oocytes (β=-0.087 p=0.049) were negatively correlated with BL. The endometrial thickness was positively correlated with GW (β=0.198 p=0.003) and BW (β=28.351 p=0.044). When each baby was classified into AGA and SGA groups, it was observed that SGA babies were derived from cycles with higher estradiol levels at hCG day (SGA: 3897.01±550.35 vs. AGA: 2324.78±101.86 p=0.006) and higher number of retrieved oocytes (SGA: 16.70±1.78 vs. AGA: 12.92±0.42 p=0.042). The endometrial thickness was significantly lower in the SGA group (SGA: 10.2±0.23 vs. AGA: 11.68±0.17 vs. p=0.029).
Higher ovarian response to stimulation and suboptimal endometrial development are associated with adverse perinatal outcomes in ICSI cycles.
研究哪些因素会影响卵胞浆内单精子注射（ICSI）周期的围产期结局。
数据来源于2014年1月至2015年12月间在一所私立大学附属体外受精中心接受ICSI周期治疗的307例患者所分娩的402例活产儿。通过线性回归模型评估周期特征对活产孕周数（GW）、婴儿出生体重（BW）和婴儿出生身长（BL）的影响，并对产妇年龄、体重指数、移植胚胎数、妊娠囊数和出生婴儿数进行校正。在后续分析中，将GW、BW和婴儿性别用于将周期分为适于胎龄（AGA，n = 256）组和小于胎龄（SGA，n = 146）组，并通过对相同混杂变量进行校正的一般线性模型进行比较。
卵泡数（β = -0.069，p = 0.018）和获卵数（β = -0.087，p = 0.049）与BL呈负相关。子宫内膜厚度与GW（β = 0.198，p = 0.003）和BW（β = 28.351，p = 0.044）呈正相关。当将每个婴儿分为AGA和SGA组时，观察到SGA婴儿来自于hCG日雌二醇水平较高的周期（SGA：3897.01±550.35 vs. AGA：2324.78±101.86，p = 0.006）和获卵数较多的周期（SGA：16.70±1.78 vs. AGA：12.92±0.42，p = 0.042）。SGA组的子宫内膜厚度明显较低（SGA：10.2±0.23 vs. AGA：11.68±0.17，p = 0.029）。
在ICSI周期中，较高的卵巢刺激反应和欠佳的子宫内膜发育与不良围产期结局相关。
