1.A study on risk factors influencing the outcomes of In vitro fertilization (IVF)
Amarzaya L ; Khadbaatar R ; Erkhembaatar T ; Gunjinlkham S ; Khulan Ch ; Jargalsaikhan B
Mongolian Journal of Health Sciences 2025;87(3):21-28
Background:
Infertility is defined as the inability of couples to conceive
despite engaging in regular, unprotected sexual intercourse for over a year.
Assisted reproductive technology (ART), particularly in vitro fertilization (IVF),
has emerged as the most widely utilized solution for infertility. The cause
of infertility, a woman's ovarian reserve, response, egg and sperm quality,
the number and quality of embryos, and various other factors influence the
outcome of IVF. Despite significant advancements in ART, predicting IVF
outcomes remains challenging, especially when tailoring treatment strategies
to individual patient factors.
Aim:
To investigate the clinical indicators, ovarian reserve markers, and
stimulation outcomes influencing the success of IVF treatment in Mongolian
women.
Materials and Methods:
A prospective study was conducted at the Unimed
International Hospital IVF Center between October 2023 and August 2024.
Clinical and demographic factors, ovarian reserve markers (FSH, AMH, AFC),
and ovarian stimulation outcomes were analyzed in 242 women aged 25-44
years undergoing IVF. Logistic regression analysis was performed to identify
risk factors and predictors of clinical pregnancy, with a statistical significance
threshold set at p<0.05.
Results:
Among 208 women who underwent embryo transfer, the clinical
pregnancy rate was 36.5%, and biochemical pregnancy was observed in
38.4%. Age was a significant predictor, with older age groups (35-39 years:
OR=7.11, p=0.004; 40-44 years: OR=12.65, p=0.004) associated with reduced
IVF success. Ovarian reserve markers, including AMH (OR=2.49, p<0.001)
and AFC (OR=1.56, p<0.001), were significantly correlated with pregnancy
outcomes, whereas FSH was not significant (p=0.518). Higher numbers of
pre-ovulatory follicles (POF) (OR=1.03, p=0.040) and high-grade embryos
(OR=1.26, p=0.045) increased the likelihood of clinical pregnancy. No
significant associations were observed between total gonadotrophin dosage,
ovarian sensitivity index, and fertilization rate with pregnancy outcomes.
Conclusion
Age and ovarian reserve markers (AMH, AFC) are critical
predictors of IVF success, while pre-ovulatory follicle counts and number
of high-grade embryos significantly enhance pregnancy likelihood. These
findings emphasize the importance of personalized ART protocols tailored to
ovarian reserve and age-related factors to optimize IVF outcomes.