Fertilization failure after IVF in 304 couples-A case-control study on predictors and long-term prognosis
Fertilization failure after IVF in 304 couples-A case-control study on predictors and long-term prognosis
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DOI：
10.1016/j.ejogrb.2014.10.037
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发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Andersen, Anders Nyboe
中科院分区：
文献类型：
--
作者：
Krog, Maria;Prior, Maria;Andersen, Anders Nyboe
目的：确定完全受精失败（TFF）的预测因素，从而优化没有明确男性因素的患者接受IVF或胞浆内单精子注射（ICSI）的初步分配。此外，为了评估长期生育预后的夫妇经历TFF.Study设计：一项回顾性病例对照研究，包括304对夫妇TFF和304个控制与IVF后受精在10年期间，从2000年至2010年。对照组为病例发生前至少有一个受精卵的患者。多元Logistic回归分析用于评估TFF的预测因素。结果：多元回归分析确定了以下TFF的独立预测因素：女性吸烟，调整优势比（AOR）1.7（95% CI 1.1-2.3），非输卵管因素AOR 2.2（95% CI 1.5-3.4），制备后的前向活动精子x 10（6）/ml（Log 2标度）AOR 1.4（95% CI 1.2-1.6）。对于每个卵母细胞，从4个卵母细胞减少到1个卵母细胞，TFF的风险增加，AOR分别为2.0（95%CI：1.5-2.9）和1.2（95%CI：1.0-1.3）。在超过7个卵母细胞的情况下，TFF的风险没有显着变化的卵母细胞的数量。女性年龄、BMI、不孕持续时间、自然受孕或IUI受孕时间较早不是TFF的预测因素。在指数周期至少30个月的随访后，50%的TFF患者成功活产，而对照组为70%。只有百分之三十五的TFF患者的出生总数后ICSI.Conclusion：TFF的风险与可用卵母细胞受精，女性吸烟，非输卵管因素不孕症和一个明显的小精子因素的数量。然而，预期的预测因素，如先进的女性年龄，不孕症的持续时间和早期概念证明没有任何预测价值。与对照组相比，经历TFF的夫妇总体活产的长期机会显著降低。(C)由Elsevier爱尔兰Ltd.出版
Objectives: To identify predictors of total fertilization failure (TFF) and thereby optimize the primary allocation of patients with no well-defined male factor to either IVF or intracytoplasmatic sperm injection (ICSI). Further, to evaluate the long-term fertility prognosis of couples experiencing TFF.Study design: A retrospective case-control study including 304 couples with TFF and 304 controls with fertilization after IVF during a 10-year period from year 2000-2010. The controls were the patients with minimum one fertilized oocyte just prior to the cases. Multiple logistic regression analysis was used to evaluate the predictors of TFF.Results: The multiple regression analysis identified the following independent predictors of TFF: female smoking, adjusted odds ratio (AOR) 1.7 (95% CI 1.1-2.3), non-tubal factor AOR 2.2 (95% CI 1.5-3.4), progressive motile spermatozoa after preparation x 10(6)/ml (Log 2 scale) AOR 1.4 (95% CI 1.2-1.6). For every oocyte, decreasing from four to one oocytes, the risk of TFF increased with AOR 2.0 (95% CI: 1.5-2.9) and from seven to four oocytes with AOR 1.2 (95%CI: 1.0-1.3), respectively. In case of more than seven oocytes the risk of TFF did not vary significantly by the number of oocytes. Female age, BMI, duration of infertility, earlier natural or IUI conceptions were not predictors of TFF. After a minimum of 30 months of follow-up from the index cycle, 50% of the TFF patients succeeded in a live childbirth compared with 70% of the controls. Only thirty five percent of the total number of births in the TFF patients was after ICSI.Conclusion: The risk of TFF is associated with the number of available oocytes for fertilization, female smoking, non-tubal factor infertility and an apparently minor sperm factor. However, anticipated predictors like advanced female age, duration of infertility and earlier conceptions proved not to have any predictive value. Couples experiencing TFF have a significantly reduced overall long-term chance of live birth compared with controls. (C) 2014 Published by Elsevier Ireland Ltd.