| Objectives:The paper is to investigate the cumulative live birth rate(CLBR)and its related factors of in vitro fertilization(IVF)/ intracytoplasmic sperm injection(ICSI)for elderly women aged 40 years and over.Methods:This paper performed the regression analysis on infertile patients from January 2016 to December 2018,who were undergoing IVF/ICSI in Reproductive Medicine Department of the Second Hospital of Hebei Medical University.This study included 433 patients in total,who were40 or over 40 years old.They were divided into 3 groups by age: group A(40-41 years old),group B(42-43 years old),and group C(≥44 years old).The differences in general conditions,laboratory indicators,pregnancy outcome in fresh cycle,and cumulative live birth rate(CLBR)were compared among all groups.This paper examined the influencing factors of the cumulative live birth rate by using Logistic regression.Results:1.There was no statistical difference in the fresh cycle transplantation rate among all groups(P>0.05).The clinical pregnancy rate of fresh cycle in group A(40-41 years old)was significantly higher than group B(42-43 years old)and group C(≥44 years old).The live birth rate of group A(40-41 years old)was higher than group C(≥44 years old),and the difference was statistically significant(P < 0.05).2.There were differences in the cumulative live birth rate among three groups(P<0.001).The pairwise comparison showed that the cumulative live birth rate of group A was higher than B and C.There was no statistical difference in the cumulative live birth rate between group B and C.3.Logistic regression analysis showed that the age,the number of oocytes collected,the number of implantable embryos,the number of high-quality embryos,and the number of embryos transferred were the influencing factors of cumulative live birth rate(P <0.05).With other confounding factors excluded,the age,the number of implantable embryos,and the number of embryo transfer cycles were the remaining independent influencing factors(P<0.05).Conclusions:1.For elderly female patients who were 40 or older,the increase in age reduced the clinical pregnancy rate and the live birth rate in the fresh cycle.2.For elderly female patients who were 40 or older,the increase in age reduced the cumulative live birth rate in a single complete ovarian stimulation cycle.3.The age,the number of implantable embryos,and the number of embryo transfer cycles were independent influencing factors of the cumulative live birth rate.The cumulative live birth rate gradually decreased with the increase in the age of the patient,the decrease in the number of implantable embryos and the increase of the number of embryo transfer cycles.For elderly female patients who are 40 or older,an appropriate treatment should be chosen.We need to obtain sufficient implantable embryos,with shorter time and fewer transplants to obtain a live birth. |
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