Perinatal outcomes of patients with diminished ovarian reserve conceived by assisted reproductive technology
Objective To explore whether women with diminished ovarian reserve(DOR)was associated with perinatal outcomes who were conceived by in-vitro fertilization/intracytoplasmic sperm injection cycles.Methods A retrospective cohort study including a total of 341 women who achieved singleton live birth after in vitro fertilization/intracytoplasmic sperm injection-fresh embryo transfer from January 2015 to April 2023 in Huzhou Maternity & Child Health Care Hospital.There were 88 patients with DOR(DOR group)and 253 patients with normal ovarian reserve(control group).Baseline data and perinatal outcomes of the two groups were observed and compared,including hypertensive disorders during pregnancy(HDP),gestational diabetes mellitus(GDM),placenta previa,placental abruption,intrahepatic cholestasis during pregnancy,preterm birth,and low birth weight.Due to the significant influence of female age on perinatal outcomes,patients in each group were divided into two subgroups with the age of 35 years as the critical value,the perinatal outcomes of patients aged＜35 years and ≥35 years were compared.The risk factors of HDP were analyzed.Results There were no significant differences between the two groups in age,body mass index,prolactin,baseline sex hormone including luteinizing hormone,estrodiol,total testosterone,systolic blood pressure and diastolic blood pressure before controlled ovarian stimulation,total gonadotropin dose,and progesterone and endometrial thickness on human chorionic gonadotropin trigger day(all P＞0.05).The levels of bilateral antral follicle count,antimullerian hormone and estradiol level on human chorionic gonadotropin trigger day in DOR group were lower than those in the control group.The basal follicle-stimulating hormone and progesterone levels were higher than those of control group,the proportion of tubal factor infertility was lower than that of control group,and the controlled ovarian stimulation days were less than those of control group,the differences of which were all statistically significant(all P＜0.05).Compared to the control group,women with DOR have significantly higher incidence of HDP(P＜0.05).There were no significant differences in the incidence of GDM,placenta previa,placental abruption,intrahepatic cholestasis during pregnancy,preterm birth and low birth weight between two groups(all P＞0.05).In patients younger than 35 years old,there was no significant difference in perinatal outcomes between the two groups(all P＞0.05).Among patients ≥35 years old,the incidence of HDP in DOR group was higher than that in control group(P＜0.05),while there were no significant differences in other perinatal outcomes between the two groups(all P＞0.05).The results of modified Poisson regression analysis showed that the risk of HDP in DOR group was significantly higher than that in control group(adjusted RR=9.34,95％CI:1.71-51.02,P=0.010).Conclusion Compared to women with normal ovarian reserve,those with diminished ovarian reserve might have elevated incidence of hypertensive diseases during pregnancy,and patients with diminished ovarian reserve need more strict antenatal care.
万方数据
维普
