Confounding variables affectingin vitro fertilization success: A decade of experience
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To evaluate etiology of infertility, female age, ovarian response and stimulation protocol in affecting in vitro fertilization (IVF) success.
Retrospective analysis was used. Computer records of all 5209 cycles initiated in 2391 couples from February 1, 1984 to December 31, 1993 were analyzed.
There were 644 intrauterine, 24 solely ectopic and 7 heterotopic pregnancies. Pregnancy rates increased with number of embryos transferred with a significant increase still found between transfer of three or four embryos. Multiple gestations also increased in association with an increasing number of embryos transferred. Pregnancy rates per cycle did not decline with repeated cycles. Reduced pregnancy rates were associated with a primary diagnosis of male infertility. Covariates associated with a better pregnancy rate were younger age of the female partner or higher peak preovulatory serum estradiol. Routine administration of GnRH-agonist was associated with a reduced cycle cancellation rate, an increase in oocytes retrieved and an improved pregnancy rate.
Couples with male infertility and increased female age should be counselled regarding the reduced prognosis for success.
Key wordsconfounding variables in vitro fertilization pregnancy
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- 4.Dicker D, Goldman JA, Ashkenazi J, Feldberg D, Shelef M, Levy T: Age and pregnancy rates in in vitro fertilization. J in Vitro Fertil Embryo Transfer 1991;8:141–144Google Scholar
- 9.Yuzpe AA, Brown SE, Casper RF, Nisker JA, Graves G: Rates and outcome of pregnancies achieved in the first 4 years of an in vitro fertilization program. Can Med Assoc J 1989;140:167–172Google Scholar
- 12.Alsalili M, Yuzpe A, Tummon I, Parker J, Martin J, Daniel S, Rebel M, Nisker J: Cumulative pregnancy rates and pregnancy outcome after in vitro fertilization: Five thousand cycles at one centre. Hum Reprod (in press)Google Scholar
- 15.Gore-Langton RE, Daniel SAJ, Nisker JA, Yuzpe AA: Superiority of HTF medium versus T6 medium in an IVF-ET controlled trial. Presented at the 49th Annual Clinical Meeting of The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada, June 22–26, 1993Google Scholar
- 17.FIVNAT: French National IVF Registry: Analysis of 1986 to 1990 data. Fertil Steril 1993;59:587–595Google Scholar
- 27.Tummon IS, Daniel SAJ, Kaplan BR, Nisker JA, Yuzpe AA: Randomized prospective comparison of luteal leuprolide acetate and gonadotropins versus clomiphene citrate and gonadotropins in 408 first cycles in vitro fertilization. 1992;58:563–568Google Scholar