9.baby, GeneraLife IVF, Bologna, Italy.
ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy.
J Assist Reprod Genet. 2022 Apr;39(4):945-952. doi: 10.1007/s10815-022-02468-2. Epub 2022 Mar 26.
To test the validity of the Vienna consensus laboratory key performance indicators (KPIs) to monitor the outcome of treatments involving women of different age ranges.
The retrospective cohort study included 862 complete IVF/ICSI cycles carried out between January 2014 and May 2021. All embryos of each cycle cohort were subject to extended culture. The overall population was divided into two groups according to female age: the Vienna consensus (≤ 39 years) and older female age (≥ 40 years). We compared outcomes of a selection of the Vienna performance indicators (PIs) and KPIs, with a focus on measures relevant to embryo cleavage and blastocyst formation. A possible association between total good blastocyst development rate (TGBDR) and cumulative clinical pregnancy rate (CPR) was also assessed.
No differences were observed in fertilization and embryo cleavage KPIs between the Vienna consensus and the older female age group (standard IVF fertilization, 67.2 vs. 67.3; ICSI fertilization, 72.3 vs. 75.3; day 2 development, 57.6% vs 58.7%; day 3 development, 52.4% vs. 50.7%, respectively). TGBDR was lower in the older female age group (45.5% vs. 33.4% p < 0.001). Multivariate logistic regression analysis indicated female age as a factor independently associated with TGBDR. Clinical outcomes significantly decreased with increasing female age.
The study suggests that, while most laboratory outcome measures are reliably applicable irrespective of female age, KPIs describing extended embryo culture should be fine-tuned in consideration of older female age.
验证维也纳共识实验室关键绩效指标(KPIs)用于监测不同年龄段女性治疗结果的有效性。
本回顾性队列研究纳入了 2014 年 1 月至 2021 年 5 月期间完成的 862 个完整 IVF/ICSI 周期。每个周期队列的所有胚胎均进行了延长培养。根据女性年龄将总体人群分为两组:维也纳共识(≤39 岁)和年龄较大的女性组(≥40 岁)。我们比较了维也纳表现指标(PIs)和 KPIs 的部分结果,重点关注与胚胎分裂和囊胚形成相关的指标。还评估了总优质囊胚发育率(TGBDR)与累积临床妊娠率(CPR)之间的可能关联。
在维也纳共识和年龄较大的女性组之间,受精和胚胎分裂 KPIs 没有差异(标准 IVF 受精率,67.2%比 67.3%;ICSI 受精率,72.3%比 75.3%;第 2 天发育率,57.6%比 58.7%;第 3 天发育率,52.4%比 50.7%)。年龄较大的女性组的 TGBDR 较低(45.5%比 33.4%,p<0.001)。多变量逻辑回归分析表明,女性年龄是与 TGBDR 相关的独立因素。随着女性年龄的增加,临床结局显著下降。
研究表明,虽然大多数实验室结果测量指标无论女性年龄如何都可靠适用,但描述延长胚胎培养的 KPIs 应根据年龄较大的女性进行调整。