高龄女性IVF/ICSI助孕临床妊娠结局影响因素研究

Study on the influencing factors of clinical pregnancy outcomes in advanced age women undergoing IVF/ICSI

目的探讨高龄女性行体外受精或卵泡浆内单精子显微注射技术(IVF/ICSI)助孕临床妊娠结局的影响因素,为高龄女性提供合理的助孕建议。方法回顾性分析2016-01~2018-12在南宁市某三甲医院生殖中心行IVF/ICSI治疗的633个周期助孕资料,依据妊娠结局分为临床妊娠组(182个周期)和未孕组(451个周期)。采用多因素Logistic回归分析妊娠结局的影响因素。结果女方年龄大(OR=0.682,95%CI=0.604~0.770)、有剖宫产史(OR=0.411,95%CI=0.232~0.729)、有痛经史(OR=0.257,95%CI=0.074~0.893),妊娠率降低;窦卵泡数多(OR=1.052,95%CI=1.010~1.096)、移植胚胎质量高(OR=1.310,95%CI=1.032~1.664),妊娠率增高。结论广大女性应当合理规划生育年龄,从自身预防高龄不孕症的发生。助孕机构应当对高龄助孕女性的健康状况、生育力进行细致全面地评估,对生育几率、生育风险进行客观充分地告知,综合各方面为高龄女性制定安全合理的助孕方案。

Objective To explore the influencing factors of clinical pregnancy outcomes in advanced age women undergoing in vitro fertilization or intracytoplasmic sperm injection(IVF/ICSI),and to provide rational suggestions for the patients.Methods A retrospective analysis of 633 cycles of IVF/ICSI treatment in the reproductive center of a class A tertiary hospital in Nanning city from January 2016 to December 2018 was performed.According to the clinical pregnancy outcomes,the patients were divided into the successful conception group(182 cycles)and the unsuccessful conception group(451 cycles).The influencing factors of the pregnancy outcomes were analyzed by multivariate Logistic regression analysis.Results The pregnancy rates of older women(OR=0.682,95%CI=0.604~0.770),those with cesarean section history(OR=0.411,95%CI=0.232~0.729)and those with dysmenorrhea history(OR=0.257,95%CI=0.074~0.893)were decreased.The higher the number of antral follicles(OR=1.052,95%CI=1.010~1.096)and the higher the quality of embryo transfered(OR=1.310,95%CI=1.032~1.664),the higher the pregnancy rate.Conclusion The majority of women should reasonably plan their childbearing age to prevent the occurrence of infertility in advanced age from their own.Assisted reproductive institutions should make a detailed and comprehensive assessment of the health status and fertility of advanced age women,and give objective and sufficient information on the fertility rate and risks,so as to make safe and reasonable treatment protocols for the advanced age women in all aspects.