Prognostic factors influencing fresh and frozen IVF outcomes: an analysis of the UK national database

被引:12
作者
Hirst, W. Mark [1 ]
Vail, Andy [1 ]
Brison, Daniel R. [2 ]
Roberts, Stephen A. [1 ]
机构
[1] Univ Manchester, MAHSC, Manchester M13 9WL, Lancs, England
[2] Univ Manchester, Cent Manchester NHS Fdn Trust, St Marys Hosp, Dept Reprod Med,MAHSC, Manchester M13 9WL, Lancs, England
关键词
cohort; in-vitro fertilization; outcomes; prognostic factors; statistical models; IN-VITRO FERTILIZATION; EMBRYO-TRANSFER; SINGLE-EMBRYO; MULTIPLE BIRTHS; PREGNANCY; IMPACT; RECIPIENTS; HEALTH; AGE;
D O I
10.1016/j.rbmo.2010.12.008
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
National registry data provides a valuable resource to quantify factors which influence the outcomes of IVF treatments. Multilevel logistic regression analyses for live birth and multiple births given a live birth were undertaken using data from the UK Human Fertilization and Embryology Authority's registry of treatments conducted between 2000 and 2005. This study analysed 119,930 fresh and 19,918 frozen transfers from 85,349 patients in 84 centres. As well as quantifying the effects of a range of previously identified prognostic factors, the analyses showed that embryo cryopreservation reduced the live birth rate substantially (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.57-0.64) compared with typical fresh cycles. Prognostic factors for transfers following cryopreservation were largely similar to those for fresh cycles, with some evidence that female age is less important, and there were small differences in the effects of the numbers of embryos transferred and previous IVF attempts that can be ascribed to selection effects. No factors were identified which specifically predicted twin outcomes; patients with a high twin risk were those with a high chance of treatment success. After allowing for all prognostic factors, there remained clinically important variability between centres (median OR 1.4) and between patients (median OR 1.8). (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:437 / 448
页数:12
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