Female age is associated with the optimal number of oocytes to maximize fresh live birth rates: an analysis of 256,643 fresh ART cycles.
Reprod Biomed Online
; 42(3): 669-678, 2021 Mar.
Article
em En
| MEDLINE
| ID: mdl-33509664
ABSTRACT
RESEARCH QUESTION What is the optimal number of oocytes retrieved at which maximum live birth rate is observed after fresh autologous assisted reproductive technology (ART) cycles for women of different ages? DESIGN:
Retrospective cohort study of all fresh autologous ART aspiration cycles (nâ¯=â¯256,643) undertaken in Australia and New Zealand between 2009 and 2015. Primary outcome measure was live birth rate (LBR) (delivery of at least one liveborn baby at 20 weeks' gestation or over per fresh aspiration cycle). Cycles were grouped according to female age (<30, 30-34, 35-49, 40-44 and ≥45 years) and ovarian response (one to three, four to nine, 10-14, 15-19, 20-25 and ≥25 oocytes). Secondary outcome was incidence of ovarian hyperstimulation syndrome (OHSS) requiring hospitalization.RESULTS:
At different oocyte yields, LBR per fresh aspiration cycle peaked and then declined at, depending on female age <30 years six to 11 oocytes (LBR 31-34%); 30-34 years 11-16 oocytes (LBR 29-30%); 35-39 years nine to 17 oocytes (LBR 21-24%); and 40-44 years 15-17 oocytes (LBR 11-12%). The incidence of OHSS increased significantly with the number of oocytes retrieved, from 1.2% with 15 oocytes retrieved to 9.3% with 30 or more oocytes retrieved (P < 0.001).CONCLUSION:
The optimal number of oocytes at which maximum LBR was observed in a fresh aspiration cycle was highly dependent on age. Because of the observational nature of the results, a cause-effect relationship between the number of oocytes retrieved and LBR should not be assumed; evidence from well-designed randomized control trials is required before clinical advice can be suggested.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oócitos
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Sistema de Registros
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Coeficiente de Natalidade
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Recuperação de Oócitos
Tipo de estudo:
Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Reprod Biomed Online
Assunto da revista:
MEDICINA REPRODUTIVA
Ano de publicação:
2021
Tipo de documento:
Article