| BackgroundThe rate of the Infertility-related diseases showed an increasing trend. In vitro fertilization (IVF) is an effective treatment and sometimes it is even the sole method appropriate. Promoting its clinical-pregnancy rate and live-birth rate are two hot topics for researching issues.ObjectiveTo invesigate the IVF clinical pregnancy and live birth rate, as well as their trends in an infertility treatment center from 2005 to 2010. Comprehensive analysis of the individuals and clinical factors by analyzing the logical relationship between IVF technology implementation process was performed to explore some valuable factors to improve the success rate of IVF.Data and MethodsWe collect all the IVF cases in Shanghai Jiai infertility and genetic diagnosis and treatment center from 2005 to 2010.And the general condition of the patients and their clinical data were retrieved from electronic medical records, the information of childbirth was obtained through follow-up after a successful pregnancy. Clinical success rate and live birth rate for fresh cycles/freezing cycles, and the cumulative success rate of single-cycle among different years were primary indexes for analysis. And we also analyzed all the relevant factors which may influence the success rate of IVF. Data was analyzed by SPSS 16.0 software package. Statistical methods include chi-square test, stratified analysis, trend test, and two Logistic regression analysis.ResultsThe number of IVF-ET cases in the center was respectively 1004,1328,1359,1853, 2220,2029 from 2005 to 2010, and the total of cases was 9793.The clinical pregnancy rate(single transplant) for fresh cycles was 35.5%, while the rates stratified by year were 40.7%,39.9%,36.7%,38.3%,34.3%,31.6% from 2005 to 2010, indicating a declining trend. Multivariate analysis showed that age, endometrial thickness, length of program, and Gn(Gonadotropin-releasing hormone analogs, Gn) dosage have a significant impact on pregnancy success rate. The total five-year (2005-2009)Iive births rate was 27.9%, which stratified by year were 32.8%,30.3%, 28.2%,27.2%,25.1%,and they were about 7%-9% less than pregnancy success rates. Multivariate analysis also found that members of different experiments may generate impact on the success rate.The clinical pregnancy rates(single transplant) for freezing cycles (stratified by year) were 35.6%,37.8%,36.7%,33.1%,28.5%,31% from 2005 to 2010,and they decreased gradually from 2007, to the minimum in 2009, but appeared to rise in 2010. Multivariate analysis showed that age, endometrial thickness, the number of frozen ovum had significant impact on pregnancy success rate. The live births rates stratified by year were 35.1%, 35.9%,34.9%,31.5%,27.1% from 2005 to 2009, presenting a significant declining trend. The overall cumulative pregnancy rates were 65.2%,64.6%,57.8%,50.4%,54.1%,45.0% from 2005 to 2010. The five-year(2005-2009) live birth rates stratified by the times of transplants were 22.9%,35.7%,39.3%,39.8%,40.2%,40.2%,40.2%.ConclusionThe age of women was one of the most important factors affecting IVF-ET clinical pregnancy rate and live-birth rate.As the growth of the age, the success rate lowed rapidly. After the diagnosis of infertility, women should be encouraged to do the implementation of assisted reproductive technology as early as they can.The dosage of Gn should increase carefully when did the operation and the number of the collected eggs should not be too many. Measures should be taken to increase women endometrial thickness and some technical service person should be trained to increase the IVF success rate. |
PDF Full Text Request