METHODS: A retrospective cohort study was performed to analyze the clinical data of 4,203 infertile women aged ≤ 35 years who underwent fresh embryo transfer (ET) in IVF/ICSI cycles. The data were collected from their initial visits to Fujian Maternity and Child Health Hospital between January 2015 and January 2022. Based on their ovarian reserve, the participants were categorized into two groups: DOR group (n = 1,027) and non-DOR group (n = 3,176). A propensity score matching (PSM) method was employed to ensure a relatively balanced distribution of covariates. The primary outcome assessed in this study was the live birth rate, while the secondary observation indicators included rates of high-quality embryo development, blastocyst formation, clinical pregnancy, and miscarriage, along with perinatal complications, neonatal birth weight, and the incidence of low birth weight (LBW).
RESULTS: The DOR group showed notably lowered rates of blastocyst formation (59.8% vs. 64.1%), embryo implantation (29.8% vs.33.3%), clinical pregnancy (47.9% vs. 53.6%), and live birth (40.6% vs. 45.7%) compared to the non-DOR group (all P < 0.05). However, no statistically significant differences were observed in the high-quality embryo rate, miscarriage rate, perinatal complications, neonatal birth weight, or LBW incidence in infants between both groups (all P > 0.05).
CONCLUSIONS: DOR has been found to reduce both clinical pregnancy and live birth rates in young females undergoing fresh ET in IVF/ICSI cycles. However, this reduction does not increase the risk of perinatal complications or LBW of infants through live birth cycles.
方法:采用回顾性队列研究方法,对4203例年龄≤35岁的不孕妇女进行IVF/ICSI周期新鲜胚胎移植(ET)的临床资料进行分析。数据收集自2015年1月至2022年1月在福建省妇幼保健院的初次就诊。根据他们的卵巢储备,参与者分为两组:DOR组(n=1,027)和非DOR组(n=3,176).采用倾向评分匹配(PSM)方法来确保协变量的相对平衡分布。这项研究评估的主要结果是活产率,而次要观察指标包括优质胚胎发育率,囊胚形成,临床妊娠,和流产,伴随着围产期并发症,新生儿出生体重,和低出生体重(LBW)的发生率。
结果:DOR组囊胚形成率显著降低(59.8%vs.64.1%),胚胎植入(29.8%vs.33.3%),临床妊娠(47.9%vs.53.6%),和活产(40.6%vs.45.7%)与非DOR组相比(均P<0.05)。然而,优质胚胎率无统计学差异,流产率,围产期并发症,新生儿出生体重,两组婴儿的LBW发生率(均P>0.05)。
结论:已发现DOR可降低IVF/ICSI周期中接受新鲜ET的年轻女性的临床妊娠率和活产率。然而,这种降低不会增加活产周期婴儿的围产期并发症或LBW的风险.