Wang Qiumin, Qi Dan, Zhang Lixia, Wang Jingru, Du Yanbo, Lv Hong, Yan Lei
Center for Reproductive Medicine, Shandong University, Jinan 250012, China.
Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan 250012, China.
J Clin Med. 2023 Jan 6;12(2):493. doi: 10.3390/jcm12020493.
The cumulative live birth rate (CLBR) can better reflect the overall treatment effect by successive treatments, and continuous rather than categorical variables as exposure variables can increase the statistical power in detecting the potential correlation. Therefore, the dose-response relationships might find an optimal dose for the better CLBR, offering evidence-based references for clinicians. To determine the dose-response relationships of the factors and the optimal ranges of the factors in assisted reproductive technology (ART) associated with a higher CLBR, this study retrospectively analyzed 16,583 patients undergoing the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) from January 2017 to January 2019. Our study demonstrated the optimal ranges of age with a higher CLBR were under 32.10 years. We estimated the CLBR tends to increase with increased levels of AMH at AMH levels below 1.482 ng/mL, and the CLBR reaches a slightly high level at AMH levels in the range from 2.58-4.18 ng/mL. The optimal ranges of basal FSH with a higher CLBR were less than 9.13 IU. When the number of cryopreserved embryos was above 1.055 and the number of total transferred embryos was 2, the CLBR was significantly higher. In conclusion, there is a non-linear dose-response relationship between the CLBR with age, AMH, basal FSH, and the number of cryopreserved embryos and total transferred embryos. We proposed the optimal ranges of the five factors that were correlated with a higher CLBR in the first oocyte retrieval cycle, which may help consultation at IVF clinics.
累积活产率（CLBR）能够通过连续治疗更好地反映整体治疗效果，并且将连续变量而非分类变量作为暴露变量可提高检测潜在相关性的统计效能。因此，剂量反应关系可能会找到一个能实现更佳CLBR的最佳剂量，为临床医生提供循证参考。为了确定辅助生殖技术（ART）中与较高CLBR相关的因素的剂量反应关系以及这些因素的最佳范围，本研究回顾性分析了2017年1月至2019年1月期间接受首次体外受精（IVF）或卵胞浆内单精子注射（ICSI）治疗的16583例患者。我们的研究表明，CLBR较高时的最佳年龄范围在32.10岁以下。我们估计，在抗缪勒管激素（AMH）水平低于1.482 ng/mL时，CLBR往往会随着AMH水平的升高而增加，而当AMH水平在2.58 - 4.18 ng/mL范围内时，CLBR会达到略高水平。CLBR较高时的基础促卵泡生成素（FSH）最佳范围小于9.13 IU。当冷冻胚胎数量超过1.055且总移植胚胎数为2时，CLBR显著更高。总之，CLBR与年龄、AMH、基础FSH以及冷冻胚胎数量和总移植胚胎数量之间存在非线性剂量反应关系。我们提出了在首次取卵周期中与较高CLBR相关的五个因素的最佳范围，这可能有助于体外受精诊所的咨询工作。
