Increased odds of live birth in fresh in vitro fertilization cycles with shorter ovarian stimulation

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• 作者：Nigel Pereira ; M.D.^a ; ^{nip9060@med.cornell.edu} ; Caroline Friedman ; M.D.^b ; Anne P. Hutchinson ; M.D.^b ; Jovana P. Lekovich ; M.D.^a ; Rony T. Elias ; M.D.^a ; Zev Rosenwaks ; M.D.^a
• 关键词：In vitro fertilization ; prolonged ovarian stimulation ; prolonged gonadotropin stimulation ; pregnancy outcomes
• 刊名：Fertility and Sterility
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：107
• 期：1
• 页码：104-109.e2
• 全文大小：215 K
• 卷排序：107

文摘

To investigate the impact of prolonged ovarian stimulation on pregnancy outcomes in IVF cycles with fresh day 3 ET.DesignRetrospective cohort study.SettingUniversity-affiliated center.Patient(s)All patients initiating their first IVF cycle with fresh day 3 ET. Prolonged ovarian stimulation was defined as a duration of more than two standard deviations (95th percentile) for the study cohort (i.e., >13 days).Intervention(s)None.Main Outcome Measure(s)Live birth rate was considered the primary outcome and was compared between patients undergoing ovarian stimulation for ≤13 days and >13 days. Odds ratios (OR) with 95% confidence intervals (CI) for all pregnancy outcomes after day 3 ET were calculated. The OR for live birth was adjusted using logistic regression.Result(s)A total of 6,410 and 339 patients underwent ovarian stimulation for ≤13 days and >13 days, respectively. There were no differences in the demographics or mean number of day 3 embryos transferred between the two groups. Ovarian stimulation ≤13 days was associated with increased odds of clinical pregnancy (OR 2.15, 95% CI 1.19–3.89) and live birth (OR 2.35, 95% CI 1.25–4.43). The increased odds for live birth in the ≤13-day group remained unchanged after logistic regression. Patients with clinical pregnancies in the >13-day group were younger (34.6 ± 4.91 years) compared with those who did not conceive (38.2 ± 4.72 years).Conclusion(s)Our findings suggest that ovarian stimulation ≤13 days is associated with increased odds of clinical pregnancy and live birth. In patients undergoing ovarian stimulation >13 days, younger age is associated with live birth.