Analysis Of Factors Affecting The IVF-ET Clinical Pregnancy Outcome In Women With Secondary Infertility

Objective:To investigate the impact factors of clinical pregnancy outcome in secondary infertile women with the intention to have a second baby undergoing in vitro fertilization-embryo transfer (IVF-ET)Methods:The clinical, laboratory and follow-up data of patients with secondary infertility who received IVF-ET in the women’s hospital, School of Medicine, Zhejiang University between July2012to July2014were reviewed. Impact factors of pregnancy and non-pregnancy groups were explored by univariate and logistic regression analysis. The clinical pregnancy rates of different age with different number of embryos transferred were compared. The stimulation effects and clinical outcomes of GnRH agonist long protocol, GnRH agonist short protocol and GnRH antagonist protocol were evaluated in secondary infertile patients≥40years old.Results:Among1129cycles from1099patients,376cases (33.30%) had clinical pregnancy, with753cases (66.70%) not having clinical pregnancy. These two groups had statistical significance difference in patients’ age, body mass index(BMI), basal follicle-stimulating hormone(FSH) level, antral follicle number, paternal age and number of embryos transferred(P<0.05), while only maternal age (OR=0.900,95%CI:0.873～0.928, P<0.001)and the number of embryos transferred (OR=2.248,95%CI:1.906～2.652,P<0.001) were the independent impact factors affecting the IVF-ET clinical pregnancy outcome in women with secondary infertility. There was no significant clinical pregnancy rate difference between30-40years old patients transferring two embryos and <30years old patients transferring two or three embryos (P>0.05). The clinical pregnancy rate had no statistical difference among patients≥40years old using GnRH agonist long protocol, GnRH agonist short protocol and GnRH antagonist protocol (P>0.05)Conclusions:Maternal age and number of embryos transferred have independent impact on IVF-ET clinical pregnancy outcome of secondary infertile women who have had a baby previously. We suggest that no more than two embryos should be transferred for women in their thirties to minimize the risk of multiple pregnancy while still having an acceptable pregnancy rate. The pregnancy rate of patients over40years old decreases significantly, and there is no pregnancy rate difference using GnRH agonist long protocol, GnRH agonist short protocol or GnRH antagonist protocol.