Influence of the number of previous spontaneous abortions on the pregnancy outcome of patients undergoing IVF/ICSI-ET
10.3760/cma.j.cn101441-20220305-00099
- VernacularTitle:既往自然流产次数对首次IVF/ICSI-ET助孕患者妊娠结局的影响
- Author:
Jingjing FAN
1
;
Fang YUAN
1
;
Tiantian CHENG
1
;
Hua ZHAO
1
;
Cuilian ZHANG
1
;
Qiaohua HE
1
Author Information
1. 河南省人民医院 河南大学人民医院 郑州大学人民医院生殖中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Abortion, spontaneous;
Fertilization in vitro;
Spontaneous abortion rate;
Pregnancy outcomes
- From:
Chinese Journal of Reproduction and Contraception
2023;43(8):777-783
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of previous different spontaneous abortion times on pregnancy outcomes of patients with the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was performed on the clinical data of patients with the first IVF/ICSI-ET in the Reproductive Center of Henan Provincial People's Hospital from January 1, 2010 to December 31, 2018. A total of 12 912 patients were included. According to the number of previous spontaneous abortions, the patients were divided into four groups: zero time group ( n=10 948), 1 time group ( n=1 506), 2 times group ( n=345) and ≥3 times group ( n=113). The basic data of patients and pregnancy outcomes after assisted pregnancy were compared among the four groups, and the influence of the number of previous spontaneous abortions on pregnancy outcomes of IVF/ICSI-ET patients was investigated by univariate and categorical multivariate logistic regression analysis. Results:Univariate logistic regression analysis showed that age, infertility duration, previous spontaneous abortion times, endometrial thickness, the numbers of embryos transferred and high-quality embryos transferred were all influencing factors of implantation rate, pregnancy rate, early spontaneous abortion rate and live birth rate (all P<0.001, except for the influence of endometrial thickness on early spontaneous abortion rate P=0.002). The types of embryo transferred, follicle-stimulating hormone (FSH) level, luteinizing hormone (LH) level, LH/FSH, and anti-Müllerian hormone (AMH) level all had effects on the implantation rate, the pregnancy rate, and the live birth rate (all P<0.001, except for the effect of AMH on the live birth rate P=0.002). Body mass index (BMI) was the influencing factor of early spontaneous abortion rate and live birth rate ( P=0.006, P=0.002). After adjusting for confounding factors, multiple regression analysis showed that with zero time group as the reference group, the implantation rate of ≥3 times group ( OR=0.63, 95% CI: 0.42-0.94, P=0.025) was significantly decreased; the early spontaneous abortion rate was significantly increased in 1 time group ( OR=1.56, 95% CI: 1.27-1.93, P<0.001), 2 times group ( OR=2.28, 95% CI: 1.61-3.23, P<0.001), and ≥3 times group ( OR=3.32, 95% CI: 1.89-5.82, P<0.001); the live birth rate was significantly reduced in 1 time group ( OR=0.80, 95% CI: 0.71-0.91, P<0.001), 2 times group ( OR=0.66, 95% CI: 0.52-0.84, P<0.001) and ≥3 times group ( OR=0.45, 95% CI: 0.29-0.67, P<0.001). Conclusion:The number of previous early spontaneous abortions is an independent factor affecting the implantation rate, the early spontaneous abortion rate and the live birth rate for patients undergoing IVF/ICSI-ET. With the increase of the number of previous early spontaneous abortions, the implantation rate and the live birth rate after IVF/ICSI were gradually decreased, and the risk of early spontaneous abortion gradually increased.
