体外受精/胞浆内单精子注射(Ivf/Icsi)早期妊娠丢失的预测因素:1806例胚胎移植的回顾性研究

Karine Morcel, P. Merviel, P. James, S. Bouée, Mathilde Le Guillou, D. Pertuisel, J. Chabaud, S. Roche, Aurore Perrin, H. Drapier, D. Beauvillard
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摘要

早孕流产(EPL)是一种自然流产的临床妊娠在其余三个月。对EPL的几个影响因素进行了研究,但结果并不一致。我们在ART中心进行了一项回顾性研究,比较EPL、持续妊娠和未妊娠周期的基线数据和IVF/ICSI结果。排除异位妊娠和生化妊娠(超声未见妊娠囊)。本研究的目的是比较这些不同的周期,并分析EPL的危险因素。我们纳入了2555个IVF/ICSI周期,导致2193个卵母细胞采集和1806个胚胎移植。单因素分析显示,女性年龄、不孕症诊断及持续时间、hcg触发日雌二醇水平、子宫内膜厚度、胚胎移植日等因素是发生EPL的危险因素。在多变量分析中,只有女性年龄对EPL发生率有显著影响(p < 0.001),如果女性年龄≥35岁,OR为1.71(参考文献< 35岁= 1),如果≥38岁,OR为2.96,如果≥40岁,OR为5.31。在本研究中,我们观察到35岁以上女性EPL发生率每年增加4.15%。
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Predictive Factors of Early Pregnancy Loss During In Vitro Fertilization/ Intracytoplasmic Sperm Injection (Ivf/Icsi): Retrospective Study on 1806 Embryo Transfers
Early pregnancy loss (EPL) is a spontaneous miscarriage of a clinical pregnancy during the �rst trimester. Several factors of EPL have been studied but results were discordant. We performed a retrospective study in our ART center, comparing baseline data and IVF/ICSI outcomes between cycles with EPL, ongoing pregnancy and without pregnancy. Ectopic pregnancies and biochemical pregnancies (without visualization of a gestational sac on ultrasound) were excluded. The aim of this study is to compare these different cycles, and analyze the risk factors for EPL. We included 2555 IVF/ICSI cycles leading to 2193 oocyte pick-ups and 1806 embryo transfers. Several characteristics (women’s age, infertility diagnosis and duration, estradiol level on the day of hCG-trigger, endometrial thickness, day of embryo transfer) appeared to be risk factors of EPL in univariate analysis. Only women’s age has a signi�cant (p < 0.001) in�uence in multivariate analysis on the rate of EPL, with an OR: 1.71 if the woman’s age ≥ 35 years old (reference < 35 y.o = 1), 2.96 if ≥ 38 y.o and 5.31 if ≥ 40 y.o. In this study, we observed an increase in EPL rate by 4.15% per year in women over 35 years of age.
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