Treatment Outcomes Of Repeated IVF-ET Cycles And Its Influencing Factors

Objectives: 1. Approaching the factors affecting the treatment outcomes of repeated in vitro fertilization and embryo transfer(IVF-ET) cycles. 2. Approaching the relationship of repeated IVF-ET cycles and the treatment outcomes. Methods:Five thousand two hundred and forty-six patients who started IVF or intracytoplasmic sperm injection(ICSI) treatment during 2007 to 2011 in Tianjin Central Hospital of Obstetrics and Gynecology, Center for Reproductive Medicine were enrolled in this study. Referring to relevant medical records in our center's record room, the treatment outcomes of repeated IVF-ET cycles and its influencing factors were retrospectively analyzed.All patients must offer birth certificates and sign consent forms before treatment, and they all had the clinical indications of IVF/ICSI-ET. Exclusion criteria:(1) Excluding IVF-ET, patients who had other treatment, such as controlled ovarian stimulation(COS), artificial insemination with husband sperm(AIH) and so on.(2) Cycles not including ET due to various reasons.(3) Patients who had obtained a live birth in previous cycles.(4) Patients whose relevant information were incomplete.Among the women who had no live birth in cycle 1 and cycle 2, there were 72 patients getting a live birth in cycle 3(group A), and 207 patients still getting no live birth in cycle 3(group B). The relevant factors of cycle 1 and cycle 2 were compared between group A and group B, including age, infertility type, infertility duration, basic follicle-stimulating hormone(b FSH), basic luteinizing hormone(b LH), LH level on the day of gonadotropin(Gn), endometrial thickness on the day of human chorionic gonadotropin(h CG), LH level on the day of h CG, estradiol level on the day of h CG, number of oocytes retrieved, number of top quality embryos, number of frozen embryos, number of available embryos, fertilization rate and cleavage rate to conclude the factors affecting the treatment outcomes of repeated IVF-ET cycles.According to the age at the start of treatment, all the patients(n=5246) were divided into three groups: <35 years?35~39 years and ?40 years. Comparing the success rate between subgroups and in the whole population to conclude the relationship of repeated IVF-ET cycles and the treatment outcomes.Result: 1. Regression of binary logistic showed that in cycle 1 and cycle 2 statistically significant difference was found in age eventually(P<0.05). 2. Generally speaking, the success rate of cycle 1 was 52.6%, the success rate of cycle 2 was 38.3%, the success rate of cycle 3 was 29.1%, the success rate of cycle ?4 was 23.6%, and there was a statistically significant difference(P<0.001). 3. In <35 age group,the success rate of cycle 1 was 59.2%, the success rate of cycle 2 was 45.2%, the success rate of cycle 3 was 39.0%, the success rate of cycle ?4 was 38.2%, and there was a statistically significant difference(P<0.001). 4. In 35~39 age group,the success rate of cycle 1 was 40.0%, the success rate of cycle 2 was 28.0%, the success rate of cycle 3 was 25.5%, the success rate of cycle ?4 was 8.7%, and there was a statistically significant difference(P<0.001). 5. In ?40 age group,the success rate of cycle 1 was 21.2%, the success rate of cycle 2 was 19.6%, the success rate of cycle ?3 was 5.4%, and there was a difference. Conclusion: 1. Age is the only predictive factor of the live-birth treatment outcomes of repeated IVF-ET cycles. 2. The success rate of IVF-ET fall as women's age increased, and there is a statistically significant difference(P<0.001). 3. The success rate of IVF-ET fall as the number of cycles increased, and there is a difference(P<0.05). For infertility women whose age <35 years, in the previous cycles failed cases, can choose to start ? the fourth cycle; for infertility women whose age 35~39 years, in the previous cycles failed cases, can choose to start the third cycle, but do not recommend to continue a fourth and above cycle; for infertility women whose age ?40 years, in the previous cycles failed cases, can choose to start the second cycle, but do not recommend to continue a third and above cycle.