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In vitro fertilization-embryo transfer in patients with unexplained recurrent pregnancy loss / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 2421-2429, 2021.
Article in English | WPRIM | ID: wpr-921176
ABSTRACT
BACKGROUND@#Empiric therapy for patients with unexplained recurrent pregnancy loss (URPL) is not precise. Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age. The clinical outcomes of URPL patients who have undergone in vitro fertilization-embryo transfer (IVF-ET) require elucidation. The IVF outcome and influencing factors of URPL patients need further study.@*METHODS@#A retrospective cohort study was designed, and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included. By comparing clinical outcomes between these patients and those with tubal factor infertility (TFI), the factors affecting the clinical outcomes of URPL patients were analyzed.@*RESULTS@#The clinical pregnancy rate (35.18% vs. 34.52% in fresh ET cycles, P = 0.877; 34.48% vs. 40.27% in frozen-thawed ET cycles, P = 0.283) and live birth rate (LBR) in fresh ET cycles (27.67% vs. 26.59%, P = 0.785) were not significantly different between URPL group and TFI group. URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group (23.56% vs. 33.56%, P = 0.047), but the cumulative LBRs (34.69% vs. 38.26%, P = 0.368) were not significantly different between the two groups. The increased endometrial thickness (EMT) on the human chorionic gonadotropin day (odds ratio [OR] 0.848, 95% confidence interval [CI] 0.748-0.962, P = 0.010) and the increased number of eggs retrieved (OR 0.928, 95% CI 0.887-0.970, P = 0.001) were protective factors for clinical pregnancy in stimulated cycles. The increased number of eggs retrieved (OR 0.875, 95% CI 0.846-0.906, P < 0.001), the increased two-pronucleus rate (OR 0.151, 95% CI 0.052-0.437, P < 0.001), and increased EMT (OR 0.876, 95% CI 0.770-0.997, P = 0.045) in ET day were protective factors for the cumulative live birth outcome.@*CONCLUSION@#After matching ages, no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI. A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles, but a better normal fertilization potential will increase the possibility of a live birth.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Fertilization in Vitro / Abortion, Habitual / Retrospective Studies / Pregnancy Rate / Embryo Transfer Type of study: Observational study Limits: Female / Humans / Pregnancy Language: English Journal: Chinese Medical Journal Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Fertilization in Vitro / Abortion, Habitual / Retrospective Studies / Pregnancy Rate / Embryo Transfer Type of study: Observational study Limits: Female / Humans / Pregnancy Language: English Journal: Chinese Medical Journal Year: 2021 Type: Article