Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization
Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization
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DOI：
10.1016/j.fertnstert.2016.04.007
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发表时间：
2016-08-01
影响因子：
6.7
通讯作者：
Fabregues, Francisco
中科院分区：
文献类型：
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作者：
Gonzalez-Foruria, Inaki;Penarrubia, Juana;Fabregues, Francisco
目的：根据患者年龄、遵循博洛尼亚标准的卵巢储备状况、不孕原因以及使用 GnRH 拮抗剂对周期进行修改来分析自然周期 IVF (NC-IVF) 结果。设计：回顾性队列研究。地点：三级护理大学医院。患者：在 320 名患者中进行了 947 个自然周期。干预措施：分析一次进行的 947 次 NC-IVF 结果2010 年 1 月至 2014 年 12 月期间在中心进行。主要结果指标：每个周期开始的妊娠率、每个 ET 和每位患者的妊娠率，以及至少妊娠 12 周时的持续妊娠率。结果：在分析的三个年龄组中（= 40 岁），老年患者组每个周期的妊娠率显着较低（11.4% vs. 11.6% vs. 5.9%）。此外，流产率（7.7% vs. 34.4% vs. 50%）和持续妊娠率（10.6% vs. 7.6% vs. 3.0%）受到患者年龄的负面影响。然而，根据患者卵巢储备状态、不孕原因或 GnRH 拮抗剂对周期的修改，没有观察到差异。多变量逻辑回归证实，患者年龄是唯一可以预测 NC-IVF 周期妊娠的变量（比值比，0.93；95% 置信区间，0.88-0.98）。结论：NC-IVF 是为年轻患者提供的一种可行且“患者友好”的选择，无论其卵巢储备状况如何。(C) 2016 年，美国生殖医学会。
Objective: To analyze natural cycle IVF (NC-IVF) results according to patient age, ovarian reserve status following the Bologna criteria, cause of infertility, and modification of the cycle with the use of GnRH antagonist.Design: Retrospective cohort study.Setting: Tertiary-care university hospital.Patient(s): Nine hundred forty-seven natural cycles carried out in 320 patients.Intervention(s): Analysis of 947 NC-IVF outcomes performed in one single center between January 2010 and December 2014.Main Outcome Measure(s): Pregnancy rates per cycle started, per ET, and per patient, as well as ongoing pregnancy rate at a minimum of 12 weeks of gestation.Result(s): Among the three age groups analyzed (= 40 years), pregnancy rates per cycle were significantly lower in the older group of patients (11.4% vs. 11.6% vs. 5.9%). In addition, miscarriage rate (7.7% vs. 34.4% vs. 50%) and ongoing pregnancy rate (10.6% vs. 7.6% vs. 3.0%) were negatively affected by patient age. However, no differences were observed according to patient ovarian reserve status, cause of infertility, or modification of the cycle with GnRH antagonist. The multivariate logistic regression confirmed that patient age was the only variable that could predict pregnancy in NC-IVF cycles (odds ratio, 0.93; 95% confidence interval, 0.88-0.98).Conclusion(s): NC-IVF is a feasible and "patient-friendly'' option to be offered to young patients, independent of their ovarian reserve status. (C) 2016 by American Society for Reproductive Medicine.