Biochemical pregnancy and spontaneous abortion in first IVF cycles are negative predictors for subsequent cycles: an over 10,000 cases cohort study

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• 作者：Rui Yang ; Shuo Yang ; Rong Li ; Xinna Chen…
• 关键词：Biochemical pregnancy ; Spontaneous abortion ; Predictive value ; Clinical significance ; In vitro fertilization and embryo transfer
• 刊名：Archives of Gynecology and Obstetrics
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：292
• 期：2
• 页码：453-458
• 全文大小：383 KB
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  5.Cai QF, Wan F, Huang R et al (2011) Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients. Hum Reprod 26(9):2532-540PubMed View Article
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• 作者单位：Rui Yang (1)
  Shuo Yang (1)
  Rong Li (1)
  Xinna Chen (1)
  Haiyan Wang (1)
  Caihong Ma (1)
  Ping Liu (1)
  Jie Qiao (1)
  
  1. Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gynecology
  Obstetrics and Perinatology
  Endocrinology
  Human Genetics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0711

文摘

Purpose To identify whether biochemical pregnancy (BP) and spontaneous abortion (SA) cases have the same clinical characteristics in assisted reproductive therapy (ART), and to assess its predictive value for the subsequent cycles. Methods Retrospectively reviewed 12,174 cycles in the first in vitro fertilization and embryo transfer (IVF-ET) cycle from January 2009 to December 2012 of Peking University Third Hospital Reproductive Medical Center. Besides those patients who reached ongoing pregnancy stage, 7,598 cases were divided into three groups: group 1, lack of pregnancy (n?=?6,651); group 2, BP (n?=?520); and group 3, SA (n?=?427). We compared the basic status of patients of the three groups, including ages, body mass index, basic hormone levels, controlled ovarian hyperstimulation protocols, amount of gonadotropin use, and endometrium thickness. The reproductive outcome of the next embryo transfer cycles of the three groups was analyzed. Results 520 patients ended as BP, and 427 patients ended as SA. The age, primary infertility proportion, body mass index, basic FSH level and basic E2 level were similar among groups. Endometrial thickness, controlled ovarian hyperstimulation protocol, Gn dosage, average oocyte retrieval and ET numbers were also similar. Multivariate analysis showed that only the age (P?=?0.037, OR 1.060, 95?% CI 1.001-.120) and endometrium thickness on hCG administration day (P?=?0.029, OR 1.136, 95?% CI 1.013-.275) may result in the differences between BP and SA groups. In the subsequent ET cycles, the total BP rate was 4.37?%, clinical pregnancy rate was 37.28?%, and miscarriage rate was 8.18?%. The clinical pregnancy rates were similar among groups. However, BP group still had the highest BP rate (P?<?0.05, 7.97 vs. 4.01?% and 5.28?%), BP and SA group had higher miscarriage rate (P?<?0.05, 11.76?% and 14.75 vs. 7.41?%). Conclusion BP and SA in first IVF cycles had negative predictive value for subsequent ART outcomes.