Effect of the number of oocytes obtained on the cumulative live birth rate per oocytes retrieval cycle in in vitro fertilization-embryo transfer: a cohort study
10.3760/cma.j.cn101441-20191227-00575
- VernacularTitle:不同获卵数对体外受精-胚胎移植每取卵周期累积活产率的影响：一项队列研究
- Author:
Yun GAO
1
;
Shaodi ZHANG
1
;
Yisha YIN
1
;
Qiuyuan LI
1
;
Cuilian ZHANG
1
Author Information
1. 河南省人民医院（河南大学人民医院）生殖医学中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Fertilization in vitro;
Embryo transfer;
Cumulative live birth rate;
Number of oocytes retrieved
- From:
Chinese Journal of Reproduction and Contraception
2021;41(1):34-41
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect of age and number of oocytes obtained on the cumulative live birth rate per oocytes retrieval cycle in in vitro fertilization-embryo transfer (IVF-ET), and to explore the ideal number of oocytes obtained in IVF-ET. Methods:Totally 10 002 controlled ovarian stimulation cycles from March 2016 to December 2018 in the Reproductive Medicine Center of Henan Provincial People's Hospital were studied retrospectively. The general condition, clinical and laboratory indicators and clinical outcomes of the different oocytes obtained numbers were compared, and multivariate logistic regression analysis after adjusting confounding factors was used to investigate the effect of the number of oocytes obtained on the clinical outcomes, curve fitting and threshold effect analysis were performed to analyze the influence of the number of oocytes obtained on the cumulative live birth rate per oocytes retrieval cycle.Results:A total of 10 002 oocytes retrieval cycles were collected and a total of 5904 cycles of live births were obtained, with a total cumulative live birth rate of 59.03% (5904/10 002). The endometrial thickness on human chorionic gonadotropin (hCG) injection day was (10.31±3.09) mm, the median number of oocytes obtained was 8.00(5.00,12.00), the median number of mature oocytes was 7.00(4.00,11.00), and the median number of normal fertilization was 5.00(2.00,8.00), the median number of embryos available on day 3 (D3) was 4.00(2.00,7.00). The results of logistics regression analysis adjusted for confounding factors showed that the cumulative live birth rate per egg retrieval cycle in patients with 1-3 oocytes obtained ( OR=0.11, 95% CI=0.12-0.18), 4-6 oocytes obtained ( OR=0.32, 95% CI=0.33-0.44), 7-9 oocytes obtained ( OR=0.62, 95% CI=0.54-0.71) was significantly lower than that of patients with 10-15 oocytes obtained ( P<0.000 1), while it was significantly higher in patients with 16-20 oocytes ( OR=1.54, 95% CI=1.24-1.93) and ≥21 oocytes ( OR=2.49, 95% CI=1.76-3.52) than that in patients with 10-15 oocytes obtained ( P<0.000 1). The curve fitting and threshold effect analysis results showed that when the number of oocytes obtained was less than 19, the cumulative live birth rate increased significantly with the number of oocytes obtained, 16% increase in cumulative live birth rate for each additional oocytes ( OR=1.16, 95% CI=1.15-1.18, P<0.000 1). When the number of oocytes was ≥19, the cumulative live birth rate was stable and no longer increased ( OR=1.00, 95% CI=0.96-1.05, P=0.840 3). Conclusion:There is a curve relationship between the number of oocytes obtained and the cumulative live birth in IVF-ET cycle. When the number of oocytes obtained was <19, the cumulative live birth rate increased significantly with the increase of the number of oocytes obtained, but when the number of oocytes obtained was ≥19, the cumulative live birth rate did not increase significantly with it, but rather tend to be stable.
