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我们能否预测体外受精/卵胞浆内单精子注射的活产率?

Can we predict the IVF/ICSI live birth rate?

作者信息

Metello José Luis, Tomás Claudia, Ferreira Pedro

机构信息

Division of Reproductive Endocrinology and Infertility, Garcia de Orta Hospital, Almada, Portugal.

出版信息

JBRA Assist Reprod. 2019 Oct 14;23(4):402-407. doi: 10.5935/1518-0557.20190043.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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Can we predict the IVF/ICSI live birth rate?我们能否预测体外受精/卵胞浆内单精子注射的活产率?
JBRA Assist Reprod. 2019 Oct 14;23(4):402-407. doi: 10.5935/1518-0557.20190043.

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