TY - JOUR
T1 - Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization
T2 - An analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System
AU - Baker, Valerie L.
AU - Luke, Barbara
AU - Brown, Morton B.
AU - Alvero, Ruben
AU - Frattarelli, John L.
AU - Usadi, Rebecca
AU - Grainger, David A.
AU - Armstrong, Alicia Y.
N1 - Funding Information:
This study was designed by the first group of Clinical Research/Reproductive Scientist Training (CREST) scholars who completed the CREST program in 2006, in collaboration with the Society for Assisted Reproductive Technology (SART). The CREST program is supported by the Eunice Kennedy National Institute of Child Health and Human Development, the Clinical Research Training Program at Duke University, and the American Society for Reproductive Medicine (4) . Its goal is to provide clinicians in academic or private practice with training and networking opportunities that enable them to better contribute to clinical research in reproductive medicine. The CREST scholars chose to report on factors affecting the chance of conception and risk of pregnancy loss with assisted reproductive technology (ART) conceptions because the topic is of immediate relevance for practicing clinicians and our patients. We also hope that this report will help to inform the ongoing discussion regarding collection and reporting of variables affecting ART outcome.
PY - 2010/9
Y1 - 2010/9
N2 - Objective: To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006. Design: Retrospective cohort. Setting: Clinic-based data. Patient(s): The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen. Intervention(s): None. Main Outcome Measure(s): Clinical intrauterine gestation (presence of gestational sac) and live birth (≥22 weeks gestation and ≥300 g birth weight). Result(s): Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters. Conclusion(s): Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies.
AB - Objective: To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006. Design: Retrospective cohort. Setting: Clinic-based data. Patient(s): The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen. Intervention(s): None. Main Outcome Measure(s): Clinical intrauterine gestation (presence of gestational sac) and live birth (≥22 weeks gestation and ≥300 g birth weight). Result(s): Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters. Conclusion(s): Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies.
KW - ART outcomes
KW - Assisted reproductive technology
KW - IVF pregnancy rates
KW - ethnicity
KW - in vitro fertilization
KW - pregnancy loss
KW - race
KW - spontaneous abortion
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U2 - 10.1016/j.fertnstert.2009.07.986
DO - 10.1016/j.fertnstert.2009.07.986
M3 - Article
C2 - 19740463
AN - SCOPUS:77956183245
SN - 0015-0282
VL - 94
SP - 1410
EP - 1416
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 4
ER -