Alsalili M, Yuzpe A, Tummon I, Parker J, Martin J, Daniel S, Rebel M, Nisker J
Department of Gynaecology and Reproductive Medicine, University Hospital, University of Western Ontario, London, Canada.
Hum Reprod. 1995 Feb;10(2):470-4. doi: 10.1093/oxfordjournals.humrep.a135964.
Cumulative pregnancy rates and pregnancy outcome analysis are useful methods for advising an infertile couple of the probability of in-vitro fertilization (IVF) success. All 5209 IVF cycles in 2391 couples at University Hospital, London, Ontario, Canada, over 10 years were studied. Cumulative pregnancy rates were estimated using life table analysis. The Cox proportional hazards model was used to estimate the influence of covariates. Oocyte retrieval and embryo transfer were achieved in 84 and 64% of cycles initiated respectively. There were 644 intra-uterine and 24 ectopic pregnancies (13%/cycle initiated, 15%/oocyte retrieval and 20%/embryo transfer). Cumulative pregnancy rates following six cycles were: tubal 55%, idiopathic 65%, endometriosis 60%, multifactorial 63% and male 40%. There were 68 spontaneous abortions (10.6%) and three induced abortions for congenital anomalies. The multiple gestation rate was 22%. Caesarean section and preterm delivery rates were 35 and 20% respectively, due in part to the high proportion of multiple gestations. Of 15 deliveries which resulted in stillbirths and/or neonatal deaths, 12 were multiple gestations; 18 pregnancies (3.3%) were complicated by congenital malformations. No increases in congenital malformations or spontaneous abortions were identified. Cumulative pregnancy rates were lower in cases of male infertility. Success rates did not decline with successive IVF cycles. IVF is an evolving infertility treatment.
累积妊娠率和妊娠结局分析是为不孕夫妇提供体外受精（IVF）成功概率建议的有用方法。对加拿大安大略省伦敦市大学医院2391对夫妇在10年期间的5209个IVF周期进行了研究。使用生命表分析估计累积妊娠率。采用Cox比例风险模型估计协变量的影响。分别在启动周期的84%和64%中实现了取卵和胚胎移植。共有644例宫内妊娠和24例异位妊娠（启动周期的13%、取卵周期的15%和胚胎移植周期的20%）。六个周期后的累积妊娠率分别为：输卵管性不孕55%、特发性不孕65%、子宫内膜异位症60%、多因素不孕63%和男性因素不孕40%。有68例自然流产（10.6%）和3例因先天性异常而人工流产。多胎妊娠率为22%。剖宫产率和早产率分别为35%和20%，部分原因是多胎妊娠比例较高。在15例导致死产和/或新生儿死亡的分娩中，12例为多胎妊娠；18例妊娠（3.3%）合并先天性畸形。未发现先天性畸形或自然流产增加。男性不育病例的累积妊娠率较低。成功率不会随着连续的IVF周期而下降。IVF是一种不断发展的不孕治疗方法。
