Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province.
Center of Reproductive Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
Medicine (Baltimore). 2021 Mar 5;100(9):e25034. doi: 10.1097/MD.0000000000025034.
The implantation rate (IR) in assisted reproductive technologies such as in vitro fertilization (IVF) and intracytoplasmic sperm injection is affected by many different factors such as age, quality of embryo, and stage of embryo development. This study aimed to investigate to what extent the number of previous failed embryo transfer cycles is an independent factor affecting IR.This was a single-center, retrospective cohort study of a consecutive series of 6376 day-3 embryo transfer (ET) cycles following IVF between January 2012 and August 2018. None of the subjects underwent endometrial scratch/injury prior to the treatment cycle, or received intravenous immunoglobulin, steroid, dehydroepiandrosterone, intralipid or heparin during the treatment with the aim of improving implantation rates.Multiple regression analysis showed that the 3 most important independent factors affecting the IR, in decreasing of importance: age, frozen or fresh embryo transfer and the number of previous ET cycles. Having controlled for 2 of the more important confounding variables including maternal age and the type of embryo, the IR in women who had 0, 1, 2, and 3 or more previous failed ET cycles were 45.8%, 35.9%, 31.2%, 21.0%, respectively (P < .001).Repeated implantation failure is a significant independent factor affecting the IR. The number of previous failed ET cycles should be considered in counselling women regarding the prognosis of a further IVF-ET treatment cycle.
胚胎着床率(IR)在辅助生殖技术如体外受精(IVF)和卵胞浆内单精子注射中受到许多不同因素的影响,如年龄、胚胎质量和胚胎发育阶段。本研究旨在探讨既往胚胎移植失败周期数是影响 IR 的独立因素的程度。
这是一项单中心、回顾性队列研究,对 2012 年 1 月至 2018 年 8 月期间连续进行的 6376 例 IVF 第 3 天胚胎移植(ET)周期进行了研究。所有患者在治疗周期前均未进行子宫内膜搔刮/损伤,也未接受静脉免疫球蛋白、类固醇、脱氢表雄酮、脂肪乳或肝素治疗,以提高着床率。
多因素回归分析显示,影响 IR 的 3 个最重要的独立因素,重要性依次降低:年龄、冷冻或新鲜胚胎移植以及既往 ET 周期数。在控制了包括母体年龄和胚胎类型在内的 2 个更重要的混杂变量后,既往有 0、1、2 和 3 次或更多次 ET 失败的患者的 IR 分别为 45.8%、35.9%、31.2%、21.0%(P<0.001)。
反复着床失败是影响 IR 的一个显著独立因素。在对进一步 IVF-ET 治疗周期的预后进行咨询时,应考虑既往 ET 失败的周期数。