Metello José Luis, Tomás Claudia, Ferreira Pedro
Division of Reproductive Endocrinology and Infertility, Garcia de Orta Hospital, Almada, Portugal.
JBRA Assist Reprod. 2019 Oct 14;23(4):402-407. doi: 10.5935/1518-0557.20190043.
To find a pretreatment predictor for achieving a live birth. Assisted reproduction technology with IVF/ICSI is the ultimate chance for some couples to conceive a child. The expectations are high and it is important to give them a realistic perspective about the chances of achieving a live birth.
A retrospective cohort study of all IVF/ICSI cycles performed in our center between 2012 and 2016. We considered only those cycles with a live birth delivery after 24 weeks, or cycles with no surplus embryos left. The following data was evaluated: AMH; AFC; age; BMI; previous diagnosis; type of treatment; number of previous deliveries; ethnicity, smoking status. Univariate and multivariate analysis were used to examine the association of live birth with baseline patient characteristics. We determined the odds-ratio for all the statistically significant variables (p<0.05), in a multivariate model. The results are presented according to the predictors founded.
739 cycles were evaluated: 9.1% were canceled; 10.2% did not have oocytes; 15.6% did not have D2 embryos; 31.4% achieved a live birth. The univariate analysis revealed statistically significant differences regarding AMH, AFC and women's age between couples with and without a live birth (p<0.001), and the cause of infertility. We found no association with live births in other variables. These variables were categorized and used in a multivariate analysis.
Age, AMH, AFC and cause, when sub-classified, are independently associated with the results of an IVF/ICSI treatment. These results enable couples to face real expectations in their particular scenario.
寻找实现活产的预处理预测指标。体外受精/卵胞浆内单精子注射辅助生殖技术是一些夫妇受孕的最终机会。人们期望很高，因此让他们对实现活产的可能性有一个现实的认识很重要。
对2012年至2016年在我们中心进行的所有体外受精/卵胞浆内单精子注射周期进行回顾性队列研究。我们只考虑那些在24周后有活产分娩的周期，或没有剩余胚胎的周期。评估了以下数据：抗缪勒管激素（AMH）；窦卵泡计数（AFC）；年龄；体重指数（BMI）；既往诊断；治疗类型；既往分娩次数；种族、吸烟状况。采用单因素和多因素分析来检验活产与患者基线特征之间的关联。我们在多因素模型中确定了所有具有统计学意义的变量（p<0.05）的优势比。结果根据所发现的预测指标呈现。
共评估了739个周期：9.1%的周期被取消；10.2%没有获得卵母细胞；15.6%没有获得第2天胚胎；31.4%实现了活产。单因素分析显示，有活产和无活产的夫妇在AMH、AFC和女性年龄方面存在统计学显著差异（p<0.001），以及不孕原因。我们发现其他变量与活产无关联。这些变量被分类并用于多因素分析。
年龄、AMH、AFC以及细分后的病因与体外受精/卵胞浆内单精子注射治疗结果独立相关。这些结果使夫妇能够在其特定情况下面对现实的期望。
