P-83: Multivariate co-relational analysis of pregnancy outcome in a cohort of Indian population undergoing ART

Abstract

The efficiency of IVF-ET in humans is low with less than 30% of embryos that are transferred ever achieving their full developmental potential. Even after implantation, approximately 20% of all recognized pregnancies fail to progress beyond the first trimester. Various parameters such as material age, endometrial thickness, embryo quality, number of embryos transferred. D-14 post ET βHCG valves, have been suggested as predictive factors for pregnancy outcome. The objective of our study was to evaluate the co-relation between multiple variables, namely maternal age, number of eggs retrieved, number of embryos formed, quality of embryo (cellular stage and morphology), number of embryos transferred, D14 post ET Sr. βHCG level, and pregnancy outcome. A retro-spective clinical study. All women undergoing ART between January 2005 to March 2006 were analysed for pregnancy, early pregnancy loss and term deliveries. Predictive factors for achieving a live birth investigated were : maternal age, number of eggs retrieved, number of embryos transfered ,embryo quality, D 14 βHCG values. Multiple logistic regression analysis was carried out to find correlations (if any) between the variables at a confidence level of 95% (P < 0.05). A total of 110 ART cycles were evaluated. Cases of biochemical, clinical and term pregnancies were analysed. The results of the present study states that maternal age is negatively correlated with clinical pregnancy rate. (Y = 15.59 - 307.32, r = - 0.21). Strongly positive co-relation was found between embryo quality vs clinical pregnancy rate (Y = - 248.03 + 541.56X, r = + 0.28). and embryo quality vs full term deliveries (Y = - 0.471 + 0.059x; r = +0.24). However, in certain cases where multiple embryos (no.3) were transfered,even though the leading embryo was top quality (other two were Gr. II to III), there was early pregnancy loss. No co-relation found between number of eggs retrieved,number of embryos transfered to pregnancy outcome Sr Bhcg values >150mIU/ml were associated with term pregnancies.. D14 Sr. βHCG valves of more than 150 m IU/ml were associated with successful term pregnancy Maternal age, embryo quality (Cellular stage and morphological assessment) and Sr. βHCG D4 post ET > 150 mIU/ml could predict a successful term delivery in our series. Transferring low quality embryos with a top quality embryo may prove detrimental to successful pregnancy outcome.