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体外受精和胞浆内单精子注射治疗后活产概率的预测:中国人群的多中心回顾性研究。

Prediction of live birth probability after in vitro fertilization and intracytoplasmic sperm injection treatment: A multi-center retrospective study in Chinese population.

机构信息

State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.

Center for Global Health, Nanjing Medical University, Nanjing, China.

出版信息

J Obstet Gynaecol Res. 2021 Mar;47(3):1126-1133. doi: 10.1111/jog.14649. Epub 2021 Jan 4.

DOI:10.1111/jog.14649
PMID:33398918
Abstract

AIM

To develop a prediction model to estimate the chances of live birth over multiple cycles of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment.

METHODS

A retrospective cohort study was launched in three reproductive centers including 10 824 couples who received 14 106 treatment cycles with known pregnancy outcomes by the end of 2016. Discrete time logistic regression was used to establish the model and a nomogram was developed to predict the chance of live birth on plain paper-based final predictors.

RESULTS

Among 10 824 couples, 5809 (53.7%) ended up with a live birth with several successive transplant cycles. What's more, we found that younger female age (p < 0.001), smaller cycle number (p < 0.001), female body mass index (p < 0.001), male factor (p < 0.001), ovulation disorder (p = 0.006), and higher endometrial thickness (p < 0.001) were significantly associated with increased live birth rate. Discrimination of the model expressed by area under the curve (AUC) was 0.66.

CONCLUSION

Our study will help shape couples' expectations of their ART outcome, allowing them to plan their treatments more efficiently and prepare emotionally and financially.

摘要

目的

开发一种预测模型,以估计体外受精(IVF)和胞浆内精子注射(ICSI)治疗多个周期的活产几率。

方法

对三家生殖中心的 10824 对接受了 14106 个治疗周期的夫妇进行了回顾性队列研究,这些夫妇在 2016 年底前都有明确的妊娠结局。采用离散时间逻辑回归建立模型,并开发了一个列线图,以便根据最终预测因素在普通纸上预测活产的几率。

结果

在 10824 对夫妇中,有 5809 对(53.7%)通过多个连续的移植周期最终活产。此外,我们发现女性年龄较小(p<0.001)、周期数较少(p<0.001)、女性身体质量指数(p<0.001)、男性因素(p<0.001)、排卵障碍(p=0.006)和较高的子宫内膜厚度(p<0.001)与活产率的增加显著相关。该模型的区分度由曲线下面积(AUC)表示为 0.66。

结论

我们的研究将帮助夫妇们塑造对其 ART 结果的期望,使他们能够更有效地计划治疗,并在情感和经济上做好准备。

相似文献

1
Prediction of live birth probability after in vitro fertilization and intracytoplasmic sperm injection treatment: A multi-center retrospective study in Chinese population.体外受精和胞浆内单精子注射治疗后活产概率的预测:中国人群的多中心回顾性研究。
J Obstet Gynaecol Res. 2021 Mar;47(3):1126-1133. doi: 10.1111/jog.14649. Epub 2021 Jan 4.
2
Effects of female and male body mass indices on the treatment outcomes and neonatal birth weights associated with in vitro fertilization/intracytoplasmic sperm injection treatment in China.中国女性和男性体重指数对体外受精/卵胞浆内单精子注射治疗的治疗结局及新生儿出生体重的影响。
Fertil Steril. 2016 Aug;106(2):460-6. doi: 10.1016/j.fertnstert.2016.04.021. Epub 2016 May 4.
3
The role of intracytoplasmic sperm injection in non-male factor infertility in advanced maternal age.胞浆内单精子注射在高龄产妇非男性因素不孕中的作用。
Hum Reprod. 2017 Jan;32(1):119-124. doi: 10.1093/humrep/dew298. Epub 2016 Nov 16.
4
ICSI does not increase the cumulative live birth rate in non-male factor infertility.ICSI 并不会增加非男性因素不孕的累积活产率。
Hum Reprod. 2018 Jul 1;33(7):1322-1330. doi: 10.1093/humrep/dey118.
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Which factors are most predictive for live birth after in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) treatments? Analysis of 100 prospectively recorded variables in 8,400 IVF/ICSI single-embryo transfers.在体外受精和卵胞浆内单精子注射(IVF/ICSI)治疗后,哪些因素对活产的预测性最强?对8400例IVF/ICSI单胚胎移植中100个前瞻性记录变量的分析。
Fertil Steril. 2017 Mar;107(3):641-648.e2. doi: 10.1016/j.fertnstert.2016.12.005. Epub 2017 Jan 17.
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Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates.在输卵管结扎女性的体外受精周期中使用卵胞浆内单精子注射技术并不能提高妊娠率或活产率。
Hum Reprod. 2016 Dec;31(12):2750-2755. doi: 10.1093/humrep/dew247. Epub 2016 Oct 13.
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Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence.分析患有中重度子宫内膜异位症的妇女行 IVF/ICSI-FET 的结局:对卵巢反应和卵母细胞质量的影响。
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Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: a randomized controlled trial (NTR 5342).首次体外受精/卵胞浆内单精子注射周期后着床失败女性的子宫内膜搔刮术;能否提高活产率?SCRaTCH研究:一项随机对照试验(荷兰国家试验注册编号5342)
BMC Womens Health. 2017 Jul 21;17(1):47. doi: 10.1186/s12905-017-0378-y.
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Comparison of live-birth defects after luteal-phase ovarian stimulation vs. conventional ovarian stimulation for in vitro fertilization and vitrified embryo transfer cycles.黄体期卵巢刺激与常规卵巢刺激对体外受精和玻璃化胚胎移植周期活产缺陷的比较。
Fertil Steril. 2015 May;103(5):1194-1201.e2. doi: 10.1016/j.fertnstert.2015.02.020. Epub 2015 Mar 23.
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Estimation of Fertilization Rate, Implantation Rate, Pregnancy Rate and Live Birth Rate in Intracytoplasmic Sperm Injection in Association with Number of Attempts and Sperm Morphology.评估与尝试次数和精子形态相关的卵胞浆内单精子注射中的受精率、着床率、妊娠率和活产率。
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引用本文的文献

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Reprod Biol Endocrinol. 2024 Jul 8;22(1):76. doi: 10.1186/s12958-024-01253-3.
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Predicting personalized cumulative live birth rate after a complete in vitro fertilization cycle: an analysis of 32,306 treatment cycles in China.预测完整体外受精周期后的个性化累积活产率:中国 32306 个治疗周期的分析。
Reprod Biol Endocrinol. 2024 Jun 7;22(1):65. doi: 10.1186/s12958-024-01237-3.
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Prediction of Reproductive Outcomes of Intracytoplasmic Sperm Injection Cycles Using a Multivariate Scoring System.
使用多变量评分系统预测卵胞浆内单精子注射周期的生殖结局
J Hum Reprod Sci. 2024 Jan-Mar;17(1):33-41. doi: 10.4103/jhrs.jhrs_4_24. Epub 2024 Mar 28.
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Bilateral versus unilateral orchidopexy: IVF/ICSI-ET outcomes.双侧与单侧睾丸固定术:体外受精/卵胞浆内单精子注射-胚胎移植结局。
Front Endocrinol (Lausanne). 2024 Feb 1;15:1294884. doi: 10.3389/fendo.2024.1294884. eCollection 2024.
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Construction of the machine learning-based live birth prediction models for the first in vitro fertilization pregnant women.基于机器学习的体外受精孕妇活产预测模型的构建。
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