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年轻 POSEIDON 患者接受 IVF/ICSI 治疗周期后的累积活产率和出生结局:一项真实世界研究。

Cumulative live birth rates and birth outcomes after IVF/ICSI treatment cycles in young POSEIDON patients: A real-world study.

机构信息

Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Endocrinol (Lausanne). 2023 Mar 30;14:1107406. doi: 10.3389/fendo.2023.1107406. eCollection 2023.

Abstract

OBJECTIVE

The aim of this study was to describe the cumulative live birth rates (CLBRs) of young women with or without low prognosis according to the POSEIDON criteria after IVF/ICSI cycles and to investigate whether the diagnosis of low prognosis increases the risk of abnormal birth outcomes.

DESIGN

Retrospective study.

SETTING

A single reproductive medicine center.

POPULATION

From January 2016 to October 2020, there were 17,893 patients (<35 years) involved. After screening, 4,105 women were included in POSEIDON group 1, 1,375 women were included in POSEIDON group 3, and 11,876 women were defined as non-POSEIDON.

INTERVENTIONS

Baseline serum AMH level was measured on the D2-D3 of menstrual cycle before IVF/ICSI treatment.

MAIN OUTCOME MEASURES

Cumulative live birth rate (CLBR), birth outcomes.

RESULTS

After four stimulation cycles, the CLBRs in POSEIDON group 1, POSEIDON group 3, and non-POSEIDON group reached 67.9% (95% CI, 66.5%-69.3%), 51.9% (95% CI, 49.2%-54.5%), and 79.6% (95% CI, 78.9%-80.3%), respectively. There was no difference in gestational age, preterm delivery, cesarean delivery, and low birth weight infants between the three groups, but macrosomia was significantly higher in non-POSEIDON group, after adjusting for maternal age and BMI.

CONCLUSIONS

The POSEIDON group shows lower CLBRs than the non-POSEIDON group in young women, while the risk of abnormal birth outcomes in the POSEIDON group will not increase.

摘要

目的

本研究旨在描述接受体外受精/卵胞浆内单精子注射(IVF/ICSI)周期后符合 POSEIDON 标准的年轻女性的累积活产率(CLBR),并探讨低预后诊断是否会增加不良出生结局的风险。

设计

回顾性研究。

地点

单一生殖医学中心。

人群

2016 年 1 月至 2020 年 10 月,共有 17893 名(<35 岁)患者参与。经过筛选,4105 名女性被纳入 POSEIDON 组 1,1375 名女性被纳入 POSEIDON 组 3,11876 名女性被定义为非 POSEIDON 组。

干预

在 IVF/ICSI 治疗前的月经周期第 2-3 天测量基础血清 AMH 水平。

主要观察指标

累积活产率(CLBR)、出生结局。

结果

在四个刺激周期后,POSEIDON 组 1、POSEIDON 组 3 和非 POSEIDON 组的 CLBR 分别达到 67.9%(95%置信区间,66.5%-69.3%)、51.9%(95%置信区间,49.2%-54.5%)和 79.6%(95%置信区间,78.9%-80.3%)。三组间的胎龄、早产、剖宫产和低出生体重儿无差异,但非 POSEIDON 组的巨大儿明显更高,调整了母亲年龄和 BMI 后仍然如此。

结论

在年轻女性中,POSEIDON 组的 CLBR 明显低于非 POSEIDON 组,而 POSEIDON 组的不良出生结局风险不会增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/10098357/37ed5c01faf9/fendo-14-1107406-g001.jpg

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