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Abstract：
The objective of this study was to examine the influence of repeated embryo implantation failures on pregnancy outcomes among patients under 40 years of age undergoing in vitro fertilization/intracytoplasmic sperm injection embryo transfer (IVF/ICSI-ET).
A retrospective analysis was conducted on the clinical data of 13,172 patients who underwent 16,975 IVF/ICSI-ET treatment cycles at Henan Reproductive Hospital between January 1, 2015, and December 31, 2018. Patients were categorized into four groups based on the number of previous embryo implantation failure cycles: Group A=no implantation failure, Group B= 1 implantation failure, Group C=2 implantation failures, Group D=≥3 implantation failures. Baseline characteristics and pregnancy outcomes were compared among the four groups. The impact of the number of previous embryo implantation failures on pregnancy outcomes among IVF/ICSI-ET patients was investigated using univariate and multiple regression analyses.
Univariate logistic regression analysis demonstrated that factors such as the number of previous embryo implantation failures, female age, basal follicle count, endometrial thickness, total number of oocytes retrieved, type of cycle, number of high-quality embryos transferred, and stage of embryo development significantly affected implantation rate, clinical pregnancy rate, early spontaneous abortion rate, and live birth rate (all P < 0.05). The duration of infertility and anti-Mullerian hormone (AMH) levels were also found to influence implantation rate, clinical pregnancy rate, and live birth rate (all P < 0.05). Upon conducting multivariate logistic regression analysis and adjusting for confounding factors such as age, AMH levels, basal follicle count, endometrial thickness, total number of oocytes obtained, cycle type, number of high-quality embryos transferred, ovarian stimulation protocol, and stage of embryo development, it was revealed that, compared to Group A, Groups B, C, and D exhibited significantly lower implantation and live birth rates, as well as a significantly higher risk of early spontaneous abortion (all P < 0.05).
The number of previous embryo implantation failures is an independent factor affecting implantation rate, clinical pregnancy rate, spontaneous abortion rate and live birth rate of patients underwent IVF/ICSI-ET. With the increase of the number of previous embryo implantation failures, the implantation rate, clinical pregnancy rate and live birth rate of patients underwent IVF/ICSI-ET decreased significantly, and the rate of early spontaneous abortion gradually increased.
A retrospective analysis was conducted on the clinical data of 13,172 patients who underwent 16,975 IVF/ICSI-ET treatment cycles at Henan Reproductive Hospital between January 1, 2015, and December 31, 2018. Patients were categorized into four groups based on the number of previous embryo implantation failure cycles: Group A=no implantation failure, Group B= 1 implantation failure, Group C=2 implantation failures, Group D=≥3 implantation failures. Baseline characteristics and pregnancy outcomes were compared among the four groups. The impact of the number of previous embryo implantation failures on pregnancy outcomes among IVF/ICSI-ET patients was investigated using univariate and multiple regression analyses.
Univariate logistic regression analysis demonstrated that factors such as the number of previous embryo implantation failures, female age, basal follicle count, endometrial thickness, total number of oocytes retrieved, type of cycle, number of high-quality embryos transferred, and stage of embryo development significantly affected implantation rate, clinical pregnancy rate, early spontaneous abortion rate, and live birth rate (all P < 0.05). The duration of infertility and anti-Mullerian hormone (AMH) levels were also found to influence implantation rate, clinical pregnancy rate, and live birth rate (all P < 0.05). Upon conducting multivariate logistic regression analysis and adjusting for confounding factors such as age, AMH levels, basal follicle count, endometrial thickness, total number of oocytes obtained, cycle type, number of high-quality embryos transferred, ovarian stimulation protocol, and stage of embryo development, it was revealed that, compared to Group A, Groups B, C, and D exhibited significantly lower implantation and live birth rates, as well as a significantly higher risk of early spontaneous abortion (all P < 0.05).
The number of previous embryo implantation failures is an independent factor affecting implantation rate, clinical pregnancy rate, spontaneous abortion rate and live birth rate of patients underwent IVF/ICSI-ET. With the increase of the number of previous embryo implantation failures, the implantation rate, clinical pregnancy rate and live birth rate of patients underwent IVF/ICSI-ET decreased significantly, and the rate of early spontaneous abortion gradually increased.
摘要：
■这项研究的目的是研究重复胚胎植入失败对40岁以下接受体外受精/卵胞浆内单精子注射胚胎移植（IVF/ICSI-ET）的患者妊娠结局的影响。
■回顾性分析2015年1月1日至2018年12月31日在河南省生殖医院接受16,975个IVF/ICSI-ET治疗周期的13,172例患者的临床资料。根据先前胚胎植入失败周期的数量将患者分为四组：A组=无植入失败，B组=1例植入失败,C组=2植入失败，D组=≥3次植入失败。比较四组的基线特征和妊娠结局。使用单变量和多元回归分析研究了IVF/ICSI-ET患者中先前胚胎植入失败的数量对妊娠结局的影响。
■单变量逻辑回归分析表明，以前胚胎植入失败的次数等因素，女性年龄,基础卵泡计数,子宫内膜厚度,检索到的卵母细胞总数，循环类型,转移的高质量胚胎数量，胚胎发育阶段显著影响着床率，临床妊娠率,早期自然流产率,活产率(P均<0.05)。不孕的持续时间和抗苗勒管激素（AMH）水平也被发现影响植入率，临床妊娠率,活产率(P均<0.05)。在进行多变量逻辑回归分析并调整年龄等混杂因素后，AMH水平,基础卵泡计数,子宫内膜厚度,获得的卵母细胞总数，循环类型,转移的高质量胚胎数量，卵巢刺激方案,和胚胎发育阶段，据透露，与A组相比，B组,C,和D表现出显著较低的植入率和活产率，早期自然流产的风险显著增高(均P<0.05)。
■先前胚胎植入失败的次数是影响植入率的独立因素，临床妊娠率,IVF/ICSI-ET患者的自然流产率和活产率。随着先前胚胎植入失败数量的增加，植入率，行IVF/ICSI-ET患者的临床妊娠率和活产率明显下降,早期自然流产率逐渐升高。
■回顾性分析2015年1月1日至2018年12月31日在河南省生殖医院接受16,975个IVF/ICSI-ET治疗周期的13,172例患者的临床资料。根据先前胚胎植入失败周期的数量将患者分为四组：A组=无植入失败，B组=1例植入失败,C组=2植入失败，D组=≥3次植入失败。比较四组的基线特征和妊娠结局。使用单变量和多元回归分析研究了IVF/ICSI-ET患者中先前胚胎植入失败的数量对妊娠结局的影响。
■单变量逻辑回归分析表明，以前胚胎植入失败的次数等因素，女性年龄,基础卵泡计数,子宫内膜厚度,检索到的卵母细胞总数，循环类型,转移的高质量胚胎数量，胚胎发育阶段显著影响着床率，临床妊娠率,早期自然流产率,活产率(P均<0.05)。不孕的持续时间和抗苗勒管激素（AMH）水平也被发现影响植入率，临床妊娠率,活产率(P均<0.05)。在进行多变量逻辑回归分析并调整年龄等混杂因素后，AMH水平,基础卵泡计数,子宫内膜厚度,获得的卵母细胞总数，循环类型,转移的高质量胚胎数量，卵巢刺激方案,和胚胎发育阶段，据透露，与A组相比，B组,C,和D表现出显著较低的植入率和活产率，早期自然流产的风险显著增高(均P<0.05)。
■先前胚胎植入失败的次数是影响植入率的独立因素，临床妊娠率,IVF/ICSI-ET患者的自然流产率和活产率。随着先前胚胎植入失败数量的增加，植入率，行IVF/ICSI-ET患者的临床妊娠率和活产率明显下降,早期自然流产率逐渐升高。
