Embryo quality and IVF/ICSI-ET treatment outcomes in patients with endometriosis and infertility
10.3760/cma.j.cn101441-20240315-00096
- VernacularTitle:子宫内膜异位症相关性不孕症患者的胚胎质量及IVF/ICSI-ET结局的研究
- Author:
Xiaohan TANG
1
;
Shuli TANG
;
Minglei WANG
;
Meiling LIU
;
Heng WU
;
Meisong LU
Author Information
1. 哈尔滨医科大学附属第一医院生殖医学科，哈尔滨 150001
- Publication Type:Journal Article
- Keywords:
Endometriosis;
Infertility;
Embryo;
Clinical pregnancy rate;
Live birth rate;
Fertilization in vitro;
Sperm injection, intracytoplasmic;
Embryo transfe
- From:
Chinese Journal of Reproduction and Contraception
2024;44(8):791-797
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of endometriosis (EMT) on oocytes, embryo quality and pregnancy and delivery outcomes in infertility patients treated with in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted to select the EMT patients (383 cases, EMT group) and the infertility patients with tubal factor (1 613 cases, control group) who underwent IVF/ICSI-ET treatment in the Department of Reproductive Medicine, the First Affiliated Hospital of Harbin Medical University from January 2016 to December 2023. The cases were matched with the number of age, body mass index, anti-Müllerian hormone, proportion of infertility type, duration of infertility, ovulation stimulating therapy, insemination mode, number of previous IVF/ICSI cycles of the two groups by 1∶1 propensity score matching. Totally 285 patients with EMT and 285 patients in control group were finally included to analyze the effects of EMT on embryo quality and pregnancy outcome.Results:1) There were no statistically significant differences in the duration of gonadotropin (Gn) used, the total dosage and the initiating dosage of Gn used, and the levels of estradiol, luteinizing hormone, and progesterone on the human chorionic gonadotropin (hCG) injection day between the two groups (all P>0.05). 2) The total number of oocytes (7.48±5.15), the number of MⅡ oocytes (6.38±4.61), the number of transferable embryos (4.16±3.16), the number of high-quality embryos [2.00 (0.00, 3.00)] and the rate of two pronuclei (2PN) high-quality embryos [42.33% (602/1 422)] in EMT group were all lower than those in control group [8.45±4.86, P=0.021; 7.32±4.43, P=0.013; 4.95±3.19, P=0.003; 2.00 (1.00, 4.00), P=0.002; 48.76% (747/1 532), P=0.032], the differences were statistically significant. 3) There were no statistically significant differences in clinical pregnancy rate, embryo implantation rate, premature birth rate, early abortion rate, ectopic pregnancy rate, male/female ratio, number of weeks of delivery and cesarean section rate between the two groups with fresh cycle transplantation and with embryo freezing in fresh cycle and embryo transferred in the first resuscitation cycle (all P>0.05), the live birth rate of EMT patients with fresh cycle transplantation [29.71% (41/138)] was lower than that of control group [48.90% (89/182), P=0.023], and the difference was statistically significant. 4) EMT was not an independent factor of clinical pregnancy rate and live birth rate after IVF/ICSI treatment, but age and number of embryos transferred were independent factors of clinical pregnancy rate and live birth rate of IVF/ICSI treatment ( OR=0.923, 95% CI: 0.868-0.982, P=0.011; OR=0.890, 95% CI: 0.832-0.952, P=0.001; OR=2.408, 95% CI: 1.331-4.356, P=0.004; OR=3.838, 95% CI: 1.869-7.879, P<0.001). Conclusion:EMT may reduce the number of oocytes and MⅡ oocytes in infertility patients treated with IVF/ICSI-ET, and the quality of embryos in patients with EMT treated with IVF is worse, but it does not affect the clinical pregnancy outcome and delivery outcome in patients with EMT.
