Analysis of the influencing factors on the outcome of assisted reproductive technology in patients after malignancy treatment
Objective:To investigate the outcomes and influencing factors of assisted reproductive technology(ART)in infertile women after the treatment of malignant tumor.Methods:A retrospective analysis was conducted on 62 infertile women with malignant tumors who underwent in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)for the first time in Fujian Maternal and Child Health Hospital from January 2003 to October 2021(the study group).According to the age and egg retrieval time,a matching method was used to recruit 124(1:2)female patients with non-malignant tumors who received IVF/ICSI for the first time(the control group).The basic characteristics,ovulation induction methods,laboratory test results,and pregnancy outcomes of two groups were compared.The logistic regression was conducted to analyze the influencing factors of clinical pregnancy,and the receiver operating characteristic(ROC)curve was used to calculate the area under the curve(AUC)to evaluate the predictive power of the influencing factors.Results:Compared to the control group,the study group had lower basal antral follicle count(P＜0.05),lower total gonadotropin(Gn)use(P＜0.05),and shorter duration of Gn stimulation(P＜0.05).However,there were no statistically significant differences between the two groups in terms of age,infertility duration,basal reproductive hormones,the concentration of anti-Mullerian hormone(AMH),body mass index(BMI),insemination type,the number of eggs obtained,fertilization rate,cleavage rate,high-quality embryo formation rate,blastocyst formation rate,cumulative pregnancy rate,and clinical pregnancy rate per transplantation cycle(P＞0.05).Multivariate logistic regression analysis showed that the history of malignant tumors[OR=1.683,95％CI(0.736,3.847),P=0.217]was not a risk factor of pregnancy outcomes,while the number of eggs obtained[OR=1.150,95％CI(1.023,1.293),P=0.020]was the only independent influencing factor for malignant tumor patients.The combined prediction of age and the number of retrieved eggs had a higher clinical pregnancy efficacy than a single indicator prediction(AUC=0.786,P＜0.001).The optimal diagnostic threshold was 8 retrieved eggs combined with 41 years old,with a sensitivity of 0.814 and a specificity of 0.737.Conclusions:Good pregnancy outcomes can be achieved with ART treatment in female patients with malignant tumors.The history of malignant tumors is not a risk factor on pregnancy outcomes,and the number of eggs retrieved is positively correlated with pregnancy outcomes.Postoperative evaluation of the number of eggs retrieved combined with the patient's age could effectively predict pregnancy outcomes.
Assisted reproductive technologyMalignant tumorsPregnancy outcomesNumber of eggs retrievedInfluencing factors
万方数据
维普
