Reproductive Medicine Center, Henan Provincial People's Hospital, Zhengzhou, China.
People's Hospital of Henan University, Zhengzhou, China.
Front Endocrinol (Lausanne). 2023 Sep 29;14:1243402. doi: 10.3389/fendo.2023.1243402. eCollection 2023.
The objective of this study was to examine the influence of repeated embryo implantation failures on pregnancy outcomes among patients under 40 years of age undergoing fertilization/intracytoplasmic sperm injection embryo transfer (IVF/ICSI-ET).
A retrospective analysis was conducted on the clinical data of 13,172 patients who underwent 16,975 IVF/ICSI-ET treatment cycles at Henan Reproductive Hospital between January 1, 2015, and December 31, 2018. Patients were categorized into four groups based on the number of previous embryo implantation failure cycles: Group A=no implantation failure, Group B= 1 implantation failure, Group C=2 implantation failures, Group D=≥3 implantation failures. Baseline characteristics and pregnancy outcomes were compared among the four groups. The impact of the number of previous embryo implantation failures on pregnancy outcomes among IVF/ICSI-ET patients was investigated using univariate and multiple regression analyses.
Univariate logistic regression analysis demonstrated that factors such as the number of previous embryo implantation failures, female age, basal follicle count, endometrial thickness, total number of oocytes retrieved, type of cycle, number of high-quality embryos transferred, and stage of embryo development significantly affected implantation rate, clinical pregnancy rate, early spontaneous abortion rate, and live birth rate (all < 0.05). The duration of infertility and anti-Mullerian hormone (AMH) levels were also found to influence implantation rate, clinical pregnancy rate, and live birth rate (all < 0.05). Upon conducting multivariate logistic regression analysis and adjusting for confounding factors such as age, AMH levels, basal follicle count, endometrial thickness, total number of oocytes obtained, cycle type, number of high-quality embryos transferred, ovarian stimulation protocol, and stage of embryo development, it was revealed that, compared to Group A, Groups B, C, and D exhibited significantly lower implantation and live birth rates, as well as a significantly higher risk of early spontaneous abortion (all < 0.05).
The number of previous embryo implantation failures is an independent factor affecting implantation rate, clinical pregnancy rate, spontaneous abortion rate and live birth rate of patients underwent IVF/ICSI-ET. With the increase of the number of previous embryo implantation failures, the implantation rate, clinical pregnancy rate and live birth rate of patients underwent IVF/ICSI-ET decreased significantly, and the rate of early spontaneous abortion gradually increased.
本研究旨在探讨年龄小于 40 岁接受体外受精/卵胞浆内单精子注射胚胎移植（IVF/ICSI-ET）的患者中，反复胚胎着床失败对妊娠结局的影响。
回顾性分析 2015 年 1 月 1 日至 2018 年 12 月 31 日在河南生殖妇产医院接受 16975 个 IVF/ICSI-ET 治疗周期的 13172 例患者的临床资料。根据既往胚胎着床失败周期数将患者分为 4 组：A 组无着床失败，B 组 1 次着床失败，C 组 2 次着床失败，D 组≥3 次着床失败。比较 4 组患者的基线特征和妊娠结局。采用单因素和多因素回归分析探讨既往胚胎着床失败次数对 IVF/ICSI-ET 患者妊娠结局的影响。
单因素 logistic 回归分析显示，既往胚胎着床失败次数、女方年龄、基础窦卵泡计数、子宫内膜厚度、获卵总数、周期类型、移植优质胚胎数、胚胎发育阶段等因素均显著影响着床率、临床妊娠率、早期自然流产率和活产率（均<0.05）。不孕时间和抗苗勒管激素（AMH）水平也显著影响着床率、临床妊娠率和活产率（均<0.05）。多因素 logistic 回归分析并调整年龄、AMH 水平、基础窦卵泡计数、子宫内膜厚度、获卵总数、周期类型、移植优质胚胎数、卵巢刺激方案和胚胎发育阶段等混杂因素后发现，与 A 组相比，B、C、D 组着床率和活产率显著降低，早期自然流产风险显著增加（均<0.05）。
既往胚胎着床失败次数是影响 IVF/ICSI-ET 患者着床率、临床妊娠率、自然流产率和活产率的独立因素。随着既往胚胎着床失败次数的增加，IVF/ICSI-ET 患者的着床率、临床妊娠率和活产率显著降低，早期自然流产率逐渐升高。
