Cumulative Live Birth Rates After In-vitro Fertilization And Analysis Of Relative Factors

BackgroundIn-vitro fertilization (IVF) had become the standard treatment for infertility couples due to tubal obstruction, anovulation, endometriosis(EMs), male factors and unknown infertility. However, this method not only cost much money but also brought about physical and mental sufferings. Knowing when to stop the treatment due to poor presentation was as important as knowing the successful possibility to treat before a start. Cumulative live birth rates (CLBR) described the direct successful possibility of the whole treatment of several cycles, comparing with live birth rates (LBR). Comparing with cumulative pregnancy rates, CLBR included accidents or complications during pregnancy and describes the final result of infertility treatments. Therefore, CLBR was irreplaceably meaningful.ObjectsThe study aimed to search for the clinically useful cycle numbers for IVF-ET with the use the CLBR.The study aimed to compare the CLBR of different female ages and infertility aetiology, and described the characters of different groups.MethodsTo compare the CLBR of different infertility factors, we respectively analysed 2743 IVF cases during the year of 2011 to 2014, which were provided by Qilu hospital of Shandong University. We chose 1780 cases based on the lasting standards: the first time with IVF, primary or secondary infertility, the age of 22-47 years old, no preimplantation genetic diagnosis. Then we divided the patients into 2 big groups with the age of 35. Moreover, we divided the patients into 5 rows:tubal factor, Ems factor, anovulation factor, male factor and unknown infertility. We calculated the CLBR of oocyte-retrieval and transfer cycles for different age groups and infertility rows and made a comparison. And describes the characters of groups with following 11 factors:female age, infertility years, BMI, FSH basal level, Gn dosage and days, oocyte numbers, available embryos, transfer day, transfer embryo number, HCG thickness of uterine endometrium.4 oocyte-retrieval cycles and 6 transfer cycles were involved for the total patients.4 oocyte-retrieval cycles and 4 transfer cycles were involved for the groups and rows.Results(1) The total CLBR for the first 2 retrieval cycles and 4 transfer cycles improved a lot, after which the CLBR came into a platform.(2) The younger group achieved higher CLBR and LBR than the older group. Female age was still the most important factor for CLBR.(3) Different infertility disease got the same CLBR, especially in the younger group.(4) In the older group, patients got higher FSH level, higher BMI, more Gn aosage and days and fewer retrieved oocytes and available embryos. But there was no difference in membrane thickness in the HCG day comparing to age groups.(5) Different infertility rows got different characters. For example, older patients in row 3 got fewest oocytes and embryos available, which was opposite to row 4 and 5. Row 2 got the most Gn dosage and days, as a result, the thickest membrane.Conclusions(1) The total CLBR for the first 2 retrieval cycles and 4 transfer cycles were useful cycles. More cycles achieved little.(2) Female age was still the most important factor for CLBR.(3) Different infertility disease came the same in CLBR, especially in the younger group.(4) In the older group, patients got higher FSH level, higher BMI, more Gn dosage and days and fewer retrieved oocytes and available embryos. But there was no difference in membrane thickness in the HCG day comparing to age groups.(5) In older group, the CLBRs varid more than the younger group. The CLBR absolute value were anovulation<EMS<male factor<tubal factor<unknown infertility.(6)Different infertility rows got different characters.