Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen-thawed embryo transfers
Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen-thawed embryo transfers
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DOI：
10.1093/humrep/dep303
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发表时间：
2009-12-01
影响因子：
6.1
通讯作者：
Antoine, Jean-Marie
中科院分区：
文献类型：
--
作者：
Dessolle, Lionel;Darai, Emile;Antoine, Jean-Marie
关于卵母细胞捐赠（OD）后妊娠的决定因素，已经发表了相互矛盾的结果。我们使用 OD 模型来确定特定系列中冷冻解冻胚胎移植 (FTET) 后受者妊娠的预测因素，其中所有胚胎均冷冻保存，事先没有选择新鲜移植。我们报告了在大学三级护理中心进行的一项回顾性研究。 1992 年 1 月至 2006 年 12 月期间，对 198 名不孕妇女进行了一系列 450 个 OD FTET 周期，使用多变量分析和逻辑回归来确定妊娠的预测因素。平均 (+/- SD) 受者年龄为 35.7 岁 (+/- 4.5)。卵巢功能受损是OD的主要指征。移植胚胎的平均+/- SD（范围）数量为1.65 +/- 0.5 (1-3)。总体临床妊娠率、着床率和分娩率分别为 30%、18% 和 23%。经过单变量分析，35岁以下的受孕者、体重指数（BMI）< 30 kg/m(2)的女性、子宫内膜厚度>= 8 mm的女性、闭经女性以及子宫内膜准备前未接受垂体下调的女性的妊娠率显着较高。通过多变量分析，无论年龄如何，BMI、子宫内膜厚度和垂体下调的使用都是妊娠的独立预测因素。这项研究支持子宫内膜厚度 < 8 毫米、肥胖和在子宫内膜启动前使用 GnRH 类似物垂体下调会对妊娠率产生负面影响，与受者年龄无关。
Conflicting results have been published about the determinants of pregnancy after oocyte donation (OD). We used the OD model to determine predictive factors of pregnancy in the recipient after frozen-thawed embryo transfer (FTET) in a specific series where all the embryos were cryopreserved without any prior selection for fresh transfer.We report a retrospective study in a university tertiary care center. Multivariate analysis and logistic regression were used to identify predictive factors of pregnancy in a series of 450 OD FTET cycles in 198 infertile women between January 1992 and December 2006.The mean (+/- SD) recipient age was 35.7 (+/- 4.5). Impaired ovarian function was the main indication for OD. The mean +/- SD (range) number of embryos transferred was 1.65 +/- 0.5 (1-3). Overall clinical pregnancy, implantation and delivery rates were 30, 18 and 23%, respectively. After univariate analysis, pregnancy rates were significantly higher in recipients under 35 years, in women with a body mass index (BMI) < 30 kg/m(2), in women with an endometrial thickness of >= 8 mm, in amenorrheic women and in women not receiving pituitary down-regulation before endometrial preparation. Using multivariate analysis, the BMI, endometrial thickness and the use of pituitary down-regulation were independent predictors of pregnancy, regardless of age.This study supports that endometrial thickness of < 8 mm, obesity and the use of GnRH analogue pituitary down-regulation before endometrial priming negatively impact pregnancy rates, independently of the recipient's age.