Reproductive Medicine Center, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Statistics, Guangzhou Medical University, Guangzhou, China.
Int J Gynaecol Obstet. 2020 Aug;150(2):222-227. doi: 10.1002/ijgo.13174. Epub 2020 May 6.
To investigate the chance of live birth after several oocyte retrieval cycles in patients with diminished ovarian reserve (DOR) and identify the possible predictors.
A retrospective analysis of 931 patients with DOR who underwent in vitro fertilization at a university hospital in China between January 2012 and December 2014. All data for fresh and the associated frozen-thawed embryo transfer attempts were analyzed. Conditional and cumulative live birth rates (LBRs) were calculated. Mediation and logistic regression analyses were performed to determine the predictors of live birth.
Conditional LBRs remained around 10.0% in the first five cycles. Conservative cumulative LBRs (CLBRs) reached 22.0% after three cycles and increased to 24.8% after six cycles; optimal CLBRs increased from 12.9% to nearly 50.0% after six cycles. Patient age and the number of good-quality embryos were two key predictors in determining the conditional and conservative LBRs.
For patients with DOR, conditional LBR remained constant in the first five cycles, and patients should be encouraged to continue to three or five completed cycles to maximize their chance of live birth. Patient age and the number of good-quality embryos were two key factors to predict live birth.
探讨卵巢储备功能减退（DOR）患者多次取卵后活产的几率，并确定可能的预测因素。
对 2012 年 1 月至 2014 年 12 月在中国某大学医院接受体外受精的 931 例 DOR 患者进行回顾性分析。对所有新鲜和相关冻融胚胎移植尝试的数据进行了分析。计算了有条件和累积活产率（LBR）。进行中介和逻辑回归分析以确定活产的预测因素。
在前 5 个周期中，有条件 LBR 保持在 10.0%左右。保守累积 LBR（CLBR）在 3 个周期后达到 22.0%，在 6 个周期后增加到 24.8%；优化的 CLBR 在 6 个周期后从 12.9%增加到近 50.0%。患者年龄和优质胚胎数量是决定有条件和保守 LBR 的两个关键预测因素。
对于 DOR 患者，在前 5 个周期中，有条件 LBR 保持不变，应鼓励患者继续完成 3 个或 5 个完整周期，以最大限度地提高活产几率。患者年龄和优质胚胎数量是预测活产的两个关键因素。
