Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System
Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System
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DOI：
10.1016/j.fertnstert.2009.07.986
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发表时间：
2010-09-01
影响因子：
6.7
通讯作者：
Armstrong, Alicia Y.
中科院分区：
文献类型：
--
作者：
Baker, Valerie L.;Luke, Barbara;Armstrong, Alicia Y.
目的：利用美国辅助生殖技术学会（Society for assisted reproductive technology） 2004-2006年数据库的数据，评价辅助生殖技术（ART）临床妊娠和妊娠丢失的预测因素。设计：回顾性队列。设置：基于临床的数据。患者：研究人群包括225,889个使用自体卵母细胞和伴侣精液的新鲜胚胎移植周期。干预:没有。主要观察指标：临床宫内妊娠（存在妊娠囊）和活产（>=妊娠22周，>=出生体重300 g）。结果：母亲年龄的增加与妊娠19周前的受孕率降低和胎儿丢失增加显著相关，但与后期的妊娠丢失无关。卵胞浆内单精子注射（ICSI）、辅助孵化和增加胚胎移植数量对妊娠前三个月的受孕几率和妊娠延续有显著的积极影响，但对后期流产的风险没有影响。与白人相比，黑人、亚洲人和西班牙人的临床怀孕几率明显较低。此外，与白人相比，西班牙裔和亚洲人在妊娠中期和晚期流产的风险要大得多，而黑人在妊娠中期和晚期流产的风险要大得多。结论：某些人口统计学和抗逆转录病毒治疗参数影响受孕机会和早期妊娠丢失，而黑人种族和西班牙裔种族也与抗逆转录病毒妊娠的晚期妊娠丢失显著相关。[j] .中国农业科学（英文版），2010;39(4):444 - 444。(C) 2010年，美国生殖医学学会。)
Objective: To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006.Design: Retrospective cohort.Setting: Clinic-based data.Patient(s): The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen.Intervention(s): None.Main Outcome Measure(s): Clinical intrauterine gestation (presence of gestational sac) and live birth (>= 22 weeks gestation and >= 300 g birth weight).Result(s): Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters.Conclusion(s): Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies. (Fertil Steril (R) 2010;94:1410-6. (C) 2010 by American Society for Reproductive Medicine.)