Reljič Milan, Lovrec Vida Gavrić
University Medical Centre Maribor, Department for Reproductive Medicine, Ljubljanska ul. 5, 2000 Maribor, Slovenia.
Zdr Varst. 2019 Oct 1;58(4):173-178. doi: 10.2478/sjph-2019-0022. eCollection 2019 Dec.
The aim of the study was to determine predictive factors for live birth after in vitro fertilization with autologous oocytes in women ≥40 years of age.
Authors conducted a retrospective analysis of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles performed at the Department of Reproductive Medicine and Gynecologic Endocrinology, University Medical Centre Maribor, Slovenia between January 2006 and December 2015 in women aged 40 or more. The characteristics of patients and cycles were compared regarding live birth as the final outcome.
A total of 1920 IVF/ICSI cycles with egg retrieval in women ≥40 years of age were performed leading to 1591 embryo transfers. The live birth rate per embryo transfer was 17.3% at 40, 11.6% at 41, 8.2% at 42, 7.9% at 43, 1.9% at 44 and 0.0% at ≥45 years of age. The multivariate logistic regression model showed that besides women's age (OR 0.66, 95% CI: 0.55-0.78), the number of previous cycles (OR 0.88, 95% CI: 0.82-0.95), number of good quality embryos on day 2 (OR 1.19, 95% CI: 1.05-1.36), number of embryos transferred (OR 1.57, 95% CI: 1.19-2.07) and day 5 embryo transfer (OR 2.21, 95% CI: 1.37-3.55) were also independent prognostic factors for live birth.
The chance of in vitro fertilization success in women ≥40 years of age should not be estimated only on the woman's age, but also on other predictive factors: number of previous cycles, number of good quality embryos on day 2, number of transferred embryos and blastocyst embry transfer.
本研究的目的是确定40岁及以上女性自体卵母细胞体外受精后活产的预测因素。
作者对2006年1月至2015年12月在斯洛文尼亚马里博尔大学医学中心生殖医学和妇科内分泌科进行的40岁及以上女性的体外受精/卵胞浆内单精子注射(IVF/ICSI)周期进行了回顾性分析。以活产作为最终结局,比较患者和周期的特征。
共对40岁及以上女性进行了1920个取卵的IVF/ICSI周期,进行了1591次胚胎移植。40岁时每次胚胎移植的活产率为17.3%,41岁时为11.6%,42岁时为8.2%,43岁时为7.9%,44岁时为1.9%,45岁及以上时为0.0%。多因素逻辑回归模型显示,除了女性年龄(OR 0.66,95%CI:0.55 - 0.78)外,既往周期数(OR 0.88,95%CI:0.82 - 0.95)、第2天优质胚胎数(OR 1.19,95%CI:1.05 - 1.36)、移植胚胎数(OR 1.57,95%CI:1.19 - 2.07)和第5天胚胎移植(OR 2.21,95%CI:1.37 - 3.55)也是活产的独立预后因素。
40岁及以上女性体外受精成功的机会不应仅根据女性年龄来估计,还应考虑其他预测因素:既往周期数、第2天优质胚胎数、移植胚胎数和囊胚胚胎移植。