Multiple-factor Non-conditional Logistic Regression Analysis of Influential Factors on Embryo Implantation of in Vitro Fertilization and Embryo Transfer

Abstract

Objective To investigate influential factors on embryo transfer (ET) of in vitro fertilization and embryo transfer (IVF-ET). Methods From January 2007 to September 2009, people who were received in vitro fertilization and embryo transfer and intracytoplasmic sperm injection (ICSI) were recruited into this study. They were divided into two groups according to implantation rate, implanted group (implantation rate was 100%, n=47) and non-implanted group (implantation rate was 0, n=131). Influential factors on embryo implantation were analyzed by multivariate non-conditional logistic regression analysis by choosing whether embryo implantation or not as the independent variable and age, pathogeny, gonadotropin (Gn) dose, thickness of endometrim [at the day of injecting human chorionic gonadotrophin (hCG)], number of oocytes, in vitro fertilization and embryo transfer or intracytoplasmic sperm injection, fertilization rate, normal fertilization rate, poly spermic fertilization rate, high-quality embryo rate, embryo transfer time (menstrual cycle), and cell number of embryo transfer and fragment on embryo implantation as the independent variable. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Tianjin Medical University General Hospital. Informed consent was obtained from all participants. Results Variables in the equation of logistic regression were age (OR=0.844, 95%CI 23.10-35.44), normal fertilization rate (OR=1.019, 95%CI 46.95-100.00), high-quality embryo rate(OR=1.018, 95%CI 28.18-100.00), embryo transfer time (menstrual cycle) (OR=1.143, 95%CI 8.03-29.09), cell number of embryo transferred (OR=1.775, 95%CI 6.78-8.86). Within a certain extent (95%CI), embryo implantation rate decreased 15.6% when the age with additional 1 year; normal fertilization rate increased by 1.0% when embryo implantation rate increased by 1.9%; embryo implantation rate increased by 1.8% when high-quality embryo rate increased by 1.0%; implantation rate increased by 14.3% when embryo transfer time with additional 1 d; cell implantation rate increased by 184.0% when the cell number of embryo transferred increased by 1. Conclusion Age, normal fertilization rate, high-quality embryo rate, embryo transfer time (menstrual cycle), cell number of embryo transferred are the influential factors on embryo implantation of in vitro fertilization and embryo transfer. Key words: embryo implantation; influential factor; logistic regression analysis; in vitro fertilization and embryo transfer (IVF-ET)