Effects of age on pregnancy outcomes in patients with simple tubal factor infertility receiving frozen-thawed embryo transfer

Yi-Fei Sun,Jie Zhang,Yue-Ming Xu,Bu-Lang Gao,Zhuo-Ye Luo,Yong Sun,Gui-Min Hao

doi:10.1038/s41598-020-75124-3

Abstract

This study was to retrospectively analyze the effect of the age of embryos transfer and oocyte retrieval on the clinical pregnancy outcome in patients with simple tubal factor infertility (TFI) who received frozen-thawed embryo transfer. Patients (n = 3619) with simple TFI who underwent in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) frozen-thawed embryo transfer at our hospital were enrolled. Univariate logistic regression analysis, categorical multivariate logistic regression analysis, curve fitting and threshold effect analysis were performed. Age of embryo transfer was a significant (P < 0.05) independent risk factor affecting the clinical pregnancy, live birth, and miscarriage rates. The Clinical pregnancy outcome declined significantly after the age of 34 years. After limiting the female oocyte retrieval age to ≤ 34 years, no significant change was detected in the clinical pregnancy, live birth, or miscarriage rate with increase of transplantation age. In conclusion, in patients with simple TFI undergoing IVF/ICSI frozen-thawed embryo transfer, age is a significant independent risk factor affecting the clinical pregnancy, live birth, and miscarriage rate. Aging of oocytes has a greater impact on the clinical pregnancy in women with simple TFI than the aging of the body. Patients with TFI can freeze embryos in advance to preserve fertility.

Highlights

This study was to retrospectively analyze the effect of the age of embryos transfer and oocyte retrieval on the clinical pregnancy outcome in patients with simple tubal factor infertility (TFI) who received frozen-thawed embryo transfer
The effect of age of embryo transfer and oocyte retrieval should be clearly understood on the clinical pregnancy outcome in patients with simple TFI who are to receive frozen-thawed embryo transfer
The infertility duration, number of pregnancies, body mass index (BMI), basal follicle-forming hormone, estradiol (E2) on the trigger day, number of oocytes retrieved, and the level of two embryos transferred were significantly higher in the younger (≤ 32 years) than in the older group (> 32 years), respectively (Table 1)

Summary

Introduction

This study was to retrospectively analyze the effect of the age of embryos transfer and oocyte retrieval on the clinical pregnancy outcome in patients with simple tubal factor infertility (TFI) who received frozen-thawed embryo transfer. In patients with simple TFI undergoing IVF/ICSI frozen-thawed embryo transfer, age is a significant independent risk factor affecting the clinical pregnancy, live birth, and miscarriage rate. For patients with simple tubal factor infertility (TFI) due to blocked access to sperm and oocytes, assisted reproductive technology (ART) such as in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) has become a non-negligible option. The effect of age of embryo transfer and oocyte retrieval should be clearly understood on the clinical pregnancy outcome in patients with simple TFI who are to receive frozen-thawed embryo transfer. Group N Infertility duration Number of pregnancies (median + range) BMI (kg/m2) bFSH (mIU/ml) bE2 (pg/ml) bLH (mIU/ml) bLH/FSH bAMH (ng/ml) Endometrial thickness on trigger day (mm) E2 on trigger day (pg/ml) LH on trigger day (mIU/ml) P on trigger day (ng/ml) Number of embryos transferred 1 2 3 Clinical pregnancy rate Live birth rate Miscarriage rate Ectopic pregnancy rate Number of oocytes retrieved Years of embryo freezing (y)

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Results

Conclusion