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一次或多次体外受精周期后按产妇年龄划分的累积活产率:一项机构经验

Cumulative Live-Birth Rates by Maternal Age after One or Multiple In Vitro Fertilization Cycles: An Institutional Experience.

作者信息

Khalife Dalia, Nassar Anwar, Khalil Ali, Awwad Johnny, Abu Musa Antoine, Hannoun Antoine, El Taha Lina, Khalifeh Fatin, Abiad May, Ghazeeri Ghina

机构信息

Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

Faculty of Medicine, American University of Beirut, Beirut, Lebanon.

出版信息

Int J Fertil Steril. 2020 Apr;14(1):34-40. doi: 10.22074/ijfs.2020.5855. Epub 2020 Feb 25.

Abstract

BACKGROUND

The aim of this retrospective study is to investigate the cumulative live birth rate (CLBR) following one or more completed fertilization (IVF) cycles (up to 6 cycles) stratified by maternal age and type of infertility.

MATERIALS AND METHODS

In this retrospective study, five hundred forty-seven women who received 736 fresh ovarian stimulation/embryo transfer cycles between January 2016 and December 2016 were included in the study at a tertiary care center located in Lebanon.

RESULTS

In all women, the live birth rate for the first cycle was 33.0% [95% confidence interval (CI): 27.8-38.2]. The CLBR showed an increase with each successive fresh cycle to reach 56.9% (95% CI: 51.2-62.4) after 3 cycles and 67.9% (95% CI: of 62.5-73.0) after 6 cycles. The CLBR following 6 cycles reached 69.9% (95% CI: 63.8-75.6) in women younger than 35 years. In women older than 40 years, however, the live birth rate for the first cycle was significantly low at 3.1% (95% CI: 0.3-9.5) with a plateau in success rates after 4 cycles reaching 21.9% (95% CI: 9.2-40.0). Couples with different types of infertility had CLBRs ranging from 65% to 72%, with the exception of women with low ovarian reserve, where CLBRs reached 29.4% (95% CI: 10.3-56.0).

CONCLUSION

The CLBR at a referral center in a Middle Eastern country reached 67.9 % after 6 cycles, with variations by age and type of infertility treatment. These findings are encouraging for patients insisting to extend their treatment beyond 4 to 5 cycles.

摘要

背景

本回顾性研究的目的是调查在一个或多个完整的体外受精(IVF)周期(最多6个周期)后,按产妇年龄和不孕类型分层的累积活产率(CLBR)。

材料与方法

在这项回顾性研究中,2016年1月至2016年12月期间在黎巴嫩一家三级医疗中心接受736次新鲜卵巢刺激/胚胎移植周期的547名女性被纳入研究。

结果

在所有女性中,第一个周期的活产率为33.0%[95%置信区间(CI):27.8 - 38.2]。CLBR随着每个连续的新鲜周期而增加,3个周期后达到56.9%(95%CI:51.2 - 62.4),6个周期后达到67.9%(95%CI:62.5 - 73.0)。35岁以下女性6个周期后的CLBR达到69.9%(95%CI:63.8 - 75.6)。然而,在40岁以上的女性中,第一个周期的活产率显著较低,为3.1%(95%CI:0.3 - 9.5),4个周期后成功率趋于平稳,达到21.9%(95%CI:9.2 - 40.0)。不同类型不孕的夫妇CLBR在65%至72%之间,但卵巢储备低的女性除外,其CLBR达到29.4%(95%CI:10.3 - 56.0)。

结论

中东国家一家转诊中心的CLBR在6个周期后达到67.9%,因年龄和不孕治疗类型而异。这些发现对于坚持将治疗延长至4至5个周期以上的患者来说是令人鼓舞的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e61f/7139227/2e425844cd56/Int-J-Fertil-Steril-14-34-g01.jpg

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