Gonadotropin dose is negatively correlated with live birth rate: analysis of more than 650,000 assisted reproductive technology cycles.
Gonadotropin dose is negatively correlated with live birth rate: analysis of more than 650,000 assisted reproductive technology cycles.
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DOI：
10.1016/j.fertnstert.2015.07.1151
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发表时间：
2015-11
影响因子：
6.7
通讯作者：
Ireland JJ
中科院分区：
文献类型：
--
作者：
Baker VL;Brown MB;Luke B;Smith GW;Ireland JJ
为了评价促性腺激素总剂量与活产率的相关性，回顾分析2004年至2012年向辅助生殖技术学会报告的658,519个新鲜体外受精(IVF)自体周期的临床资料，以总卵泡刺激素(FSH)总剂量和取卵数的分类值作为主要预测变量，未用Logistic回归模型对活产率进行拟合。为了减少可能导致医生开出更高剂量FSH处方的最显著混杂因素的影响，额外的分析仅限于预后良好的患者(35岁，体重指数&30，没有诊断出卵巢储备减少、子宫内膜异位症或排卵障碍)，并包括促性腺激素治疗的持续时间。无论取多少卵母细胞，活产率均随FSH剂量的增加而显著降低。随着促卵泡激素剂量的增加，活产率显著下降的情况仍然存在于预后良好的患者中，且与女性年龄无关，但≥35岁且取卵1-5个卵母细胞的患者除外。这一分析表明，医生可能希望避免开出高剂量的FSH。然而，这项研究的结果并不证明使用微刺激或自然周期试管受精是合理的。活产率随FSH剂量的增加而降低，与取卵数无关。
To evaluate the correlation between total gonadotropin dose and live birth rate Retrospective analysis Clinic-based data 658,519 fresh autologous cycles of in vitro fertilization (IVF) reported to the Society for Assisted Reproductive Technology from 2004 to 2012 None Logistic regression models were fitted to live birth rates using categorized values for total follicle stimulating hormone (FSH) dose and number of oocytes retrieved as the primary predictor variables. To reduce the effect of the most significant confounders which may lead physicians to prescribe higher doses of FSH, additional analyses were performed limited to good prognosis patients (<35 years of age, BMI<30, no diagnosis of diminished ovarian reserve, endometriosis, or ovulatory disorder) and including duration of gonadotropin treatment. Live birth rate significantly decreased with increasing FSH dose, regardless of the number of oocytes retrieved.. The statistically significant decrease in live birth rate with increasing FSH dose remained in patients with good prognosis, and regardless of female age, except for women aged ≥35 with 1–5 oocytes retrieved. This analysis suggests that physicians may wish to avoid prescribing a high dose of FSH.. However, the results of this study do not justify the use of minimal stimulation or natural cycle IVF. Live birth rate decreased with increasing FSH dose, regardless of number of oocytes retrieved.