METHODS: Retrospective study of 1923 single euploid FET cycles in 1464 women, either in a natural cycle or a hormone replacement therapy cycle. The primary outcome was the ongoing pregnancy rate (OPR).
RESULTS: There were 990 (51.48%) ongoing pregnancies among 1923 included transfers. The OPR were 51.4%, 49.1%, 53.3% and 52.3% for women aged ≤35, >35-≤37, >37-≤40 and >40 years at oocyte retrieval (OCR), without a significant trend for decreasing OPR (P = 0.679). No significant differences in female age at embryo transfer (P = 0.609) and female age at OCR (P = 0.816) were found between the groups (ongoing pregnancy versus no pregnancy or miscarriage). Women who received good-quality embryos (P < 0.001), had a lower body mass index (BMI) (P < 0.001), had achieved at least one pregnancy previously (P < 0.001), and underwent natural cycle endometrial preparation (P < 0.001) were more likely to achieve an ongoing pregnancy. Multivariable regression analysis (adjusted for BMI, embryo quality and endometrial preparation) did not show a significant effect of female age at OCR on achieving an ongoing pregnancy. Compared with women aged ≤35 years, none of the age groups had significantly higher or lower OPR. A multinomial regression analysis showed that BMI, embryo quality and endometrial preparation were associated with miscarriage/no pregnancy versus ongoing pregnancy (P = 0.001, 0.001 and 0.001, respectively). Female age had no significant association with either outcome.
CONCLUSIONS: Female age in itself does not have a substantial impact on the OPR in single euploid FET cycles, but the OPR is impacted significantly by embryo quality, BMI, previous parity, and a natural cycle endometrial preparation protocol.
方法:对1464名妇女的1923个单整倍体FET周期进行回顾性研究,无论是在自然周期或激素替代疗法周期。主要结果是持续妊娠率(OPR)。
结果:在1923年中,有990(51.48%)正在进行的怀孕包括转移。OPR为51.4%,49.1%,53.3%和52.3%的女性年龄≤35岁,>35-≤37岁,>37-≤40岁和>40岁取卵(OCR),OPR下降趋势不显著(P=0.679)。两组之间在胚胎移植时的女性年龄(P=0.609)和OCR时的女性年龄(P=0.816)之间没有显着差异(持续怀孕与未怀孕或流产)。接受优质胚胎的女性(P<0.001),体重指数(BMI)较低(P<0.001),以前至少怀孕过一次(P<0.001),并且进行自然周期子宫内膜准备(P<0.001)更有可能实现持续妊娠。多变量回归分析(针对BMI进行调整,胚胎质量和子宫内膜准备)未显示OCR时女性年龄对实现持续妊娠的显着影响。与≤35岁的女性相比,没有一个年龄组的OPR显著升高或降低.多项回归分析表明,BMI,胚胎质量和子宫内膜准备与流产/未妊娠和持续妊娠相关(P分别为0.001,0.001和0.001).女性年龄与两种结果均无显著关联。
结论:女性年龄本身对单个整倍体FET循环中的OPR没有实质性影响,但是OPR受胚胎质量的影响很大,BMI,先前的奇偶校验,和自然周期子宫内膜制备方案。