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Women’s morbid conditions are associated with decreased odds of live birth in the first IVF/ICSI treatment: a retrospective single-center study

  • Juan J. TarínEmail author
  • Eva Pascual
  • Miguel-Ángel García-Pérez
  • Raúl Gómez
  • Antonio Cano
Assisted Reproduction Technologies
  • 38 Downloads

Abstract

Purpose

The present study aims to ascertain whether there is a causal relationship between women’s disease conditions present at the starting time of the first intended oocyte retrieval cycle and IVF/ICSI outcomes, primarily odds of live birth in the first IVF/ICSI treatment.

Methods

This is a retrospective study of infertile healthy and diseased women that had a live birth and/or exhibited a complete first oocyte retrieval cycle. Generalized Estimating Equations (GEE) models were applied to adjust standard errors for the potential correlation among women exhibiting the same infertility etiology. Confounders to be controlled for in these GEE models were previously selected following a strict stepwise methodology.

Results

Compared to healthy women, diseased women exhibited lower odds of live birth (OR (95% CI) 0.704 (0.576–0.860)). Further screening analyses indicated that subclinical iodine-deficiency hypothyroidism together with autoimmune thyroiditis contributed significantly to decrease odds of live birth (OR (95% CI) 0.720 (0.608–0.853)). Another important contribution arose from practically all the remaining morbid conditions analyzed. These diseases were individually associated with lower odds of live birth, although differences were non-significant. Notwithstanding, differences became significant after merging these diseases in a single group (OR (95% CI) 0.605 (0.394–0.930)).

Conclusion

There is a significant causal association between most diseases present at the starting time of the first intended oocyte retrieval cycle and lower odds of live birth in the first IVF/ICSI treatment.

Keywords

Disease conditions Infertility etiology In vitro fertilization Cumulative live birth Morbid conditions 

Notes

Compliance with ethical standards

This study was approved by the Ethical Committee of Clinical Investigation, Valencia University Clinical Hospital on November 30th 2017 (2017/316).

References

  1. 1.
    Tarín JJ, García-Pérez MA, Hamatani T, Cano A. Infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases. Reprod Biol Endocrinol. 2015;13:31.CrossRefGoogle Scholar
  2. 2.
    Hanley JA, Negassa A, Edwardes MD, Forrester JE. Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol. 2003;157:364–75.CrossRefGoogle Scholar
  3. 3.
    Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Hum Reprod. 2017;32:1786–801.CrossRefGoogle Scholar
  4. 4.
    Wilkinson J, Roberts SA, Vail A. Developments in IVF warrant the adoption of new performance indicators for ART clinics, but do not justify the abandonment of patient-centred measures. Hum Reprod. 2017;32:1155–9.CrossRefGoogle Scholar
  5. 5.
    Suttorp MM, Siegerink B, Jager KJ, Zoccali C, Dekker FW. Graphical presentation of confounding in directed acyclic graphs. Nephrol Dial Transplant. 2015;30:1418–23.CrossRefGoogle Scholar
  6. 6.
    Vetter TR, Mascha EJ. Bias, confounding, and interaction: lions and tigers, and bears, oh my! Anesth Analg. 2017;125:1042–8.CrossRefGoogle Scholar
  7. 7.
    Cools M, Moons E. Handling intrahousehold correlations in modeling travel comparison of hierarchical models and marginal models. Transportation Research Record : Journal of the Transportation Research Board. 2016;2565:8–17.CrossRefGoogle Scholar
  8. 8.
    Frane AV. Planned hypothesis tests are not necessarily exempt from multiplicity adjustment. J Res Pract. 2015;11, Article P2 http://jrp.icaap.org/index.php/jrp/article/view/514/417. Accessed 15 Nov 2018.
  9. 9.
    Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc B. 1995;57:289–300.Google Scholar
  10. 10.
    Walters E. The P-value and the problem of multiple testing. Reprod BioMed Online. 2016;32:348–9.CrossRefGoogle Scholar
  11. 11.
    Atkins DC, Baldwin SA, Zheng C, Gallop RJ, Neighbors C. A tutorial on count regression and zero-altered count models for longitudinal substance use data. Psychol Addict Behav. 2013;27:166–77.CrossRefGoogle Scholar
  12. 12.
    Busnelli A, Paffoni A, Fedele L, Somigliana E. The impact of thyroid autoimmunity on IVF/ICSI outcome: a systematic review and meta-analysis. Hum Reprod Update. 2016;22:775–90.CrossRefGoogle Scholar
  13. 13.
    He H, Jing S, Gong F, Tan YQ, Lu GX, Lin G. Effect of thyroid autoimmunity per se on assisted reproduction treatment outcomes: a meta-analysis. Taiwan J Obstet Gynecol. 2016;55:159–65.CrossRefGoogle Scholar
  14. 14.
    Poppe K, Autin C, Veltri F, Kleynen P, Grabczan L, Rozenberg S, et al. Thyroid autoimmunity and intracytoplasmic sperm injection outcome: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2018;103:1755–66.  https://doi.org/10.1210/jc.2017-02633.CrossRefGoogle Scholar
  15. 15.
    Cesta CE, Viktorin A, Olsson H, Johansson V, Sjölander A, Bergh C, et al. Depression, anxiety, and antidepressant treatment in women: association with in vitro fertilization outcome. Fertil Steril. 2016;105:1594–1602.e3.CrossRefGoogle Scholar
  16. 16.
    Di Nisio M, Ponzano A, Tiboni GM, Guglielmi MD, Rutjes AWS, Porreca E. Effects of multiple inherited and acquired thrombophilia on outcomes of in-vitro fertilization. Thromb Res. 2018;167:26–31.CrossRefGoogle Scholar
  17. 17.
    Oti M, Huynen MA, Brunner HG. Phenome connections. Trends Genet. 2008;24:103–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological SciencesUniversity of ValenciaBurjassotSpain
  2. 2.Institute of Health Research INCLIVAValenciaSpain
  3. 3.Department of Genetics, Faculty of Biological SciencesUniversity of ValenciaBurjassotSpain
  4. 4.Department of Pediatrics, Obstetrics and Gynecology, Faculty of MedicineUniversity of ValenciaValenciaSpain
  5. 5.Service of Obstetrics and GynecologyUniversity Clinic HospitalValenciaSpain

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