Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Dr. Moliner 50, Burjassot, Valencia, 46100, Spain; Research Unit on Women's Health-Institute of Health Research INCLIVA, Av. de Menéndez y Pelayo, 4, 46010, Valencia, Spain.
Research Unit on Women's Health-Institute of Health Research INCLIVA, Av. de Menéndez y Pelayo, 4, 46010, Valencia, Spain; Service of Obstetrics and Gynecology, University Clinic Hospital, Av. de Blasco Ibáñez, 17, 46010, Valencia, Spain.
Eur J Obstet Gynecol Reprod Biol. 2020 May;248:198-203. doi: 10.1016/j.ejogrb.2020.03.030. Epub 2020 Mar 19.
To ascertain whether women with a history of biochemical pregnancies (BPs) in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment cycles have decreased chances of live birth (LB); and (2) to build a predictive model for LB in this particular population of infertile women.
In order to achieve the first objective, data from 1536 women that had a LB using autologous fresh or frozen embryos, or dropped out of further IVF/ICSI treatments after completing one to three unsuccessful treatment cycles were retrospectively analyzed. A subpopulation of 90 women that experienced one or more BPs in our assisted reproduction unit were selected to build a predictive logistic regression model for LB.
LB percentages significantly decreased from a value of 55.3 % in women with no history of previous BPs to 30.9 % and 11.1 % in women that displayed a history of one or more than one BP, respectively. Three out of 35 selected potential predictors were finally included into the model: "number of the last embryo transfer cycle resulting in a BP", "women's age", and "oligo-, astheno-, and/or teratozoospermia". The value of the c-statistic was 0.819 (asymptotic 95 % CI: 0.724-0.913). The model adequately fitted the data with no significant over or underestimation of predictor effects.
(1) A history of BPs is negatively associated with later chance of LB in women undergoing a series of IVF/ICSI treatment cycles; and (2) LB probability of women with a history of BPs can be predicted using a model with excellent discriminatory capacity.
确定体外受精（IVF）/卵胞浆内单精子注射（ICSI）治疗周期中曾有生化妊娠（BP）史的女性活产（LB）的机会是否降低；并（2）为该特定不孕女性人群建立 LB 的预测模型。
为了实现第一个目标，回顾性分析了 1536 名使用自体新鲜或冷冻胚胎获得 LB 的女性的数据，或在完成一至三个不成功的治疗周期后退出进一步的 IVF/ICSI 治疗。选择我们辅助生殖单位中经历过一次或多次 BP 的 90 名女性亚群，建立 LB 的预测逻辑回归模型。
LB 的百分比从无先前 BP 史的女性的 55.3%显著降低至经历过一次或多次 BP 的女性的 30.9%和 11.1%。35 个选定的潜在预测因子中有 3 个最终纳入模型：“导致 BP 的最后一个胚胎移植周期的数量”、“女性年龄”和“少精症、弱精症和/或畸形精症”。C 统计量的值为 0.819（渐近 95%置信区间：0.724-0.913）。该模型充分拟合了数据，没有显著的预测因子效应过高或过低估计。
（1）BP 史与接受一系列 IVF/ICSI 治疗周期的女性以后 LB 的机会呈负相关；（2）使用具有出色判别能力的模型可以预测有 BP 史的女性的 LB 概率。
