Risk Factors of Pregnancy Failure in Infertile Patients Undergoing Assisted Reproductive Technology
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Abstract
Background: Assisted Reproductive Technology (ART) represents a critical advancement in the treatment of infertility, providing hope to many couples struggling to conceive naturally. Despite its success, pregnancy failure remains a significant concern, influenced by various factors such as age, BMI, and underlying medical conditions.
Objective: The main objective of this study was to identify the risk factors associated with pregnancy failure in infertile patients undergoing ART treatments.
Methods: This clinical audit was conducted at Bahria International Hospital, Rawalpindi, from January 2023 to January 2024. Data were collected from 85 patients undergoing ART treatments, including In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI). The study included comprehensive demographic information, clinical history, ART cycle details, laboratory results, and lifestyle factors. Pregnancy failure was defined as either biochemical pregnancy loss or clinical pregnancy loss. Ethical approval was obtained, and data were analyzed using SPSS version 25. Descriptive statistics summarized patient characteristics, while comparative analysis and multivariate logistic regression were used to identify significant risk factors.
Results: The study included 85 patients with a mean age of 34.5 years. Those experiencing pregnancy failure had a higher mean age of 36.2 years compared to 33.2 years in those without pregnancy failure. The mean BMI was higher in the pregnancy failure group (26.0 kg/m²) versus the no pregnancy failure group (23.8 kg/m²). Significant risk factors for pregnancy failure included older age (OR=1.15, 95% CI 1.05-1.25, p=0.002), higher BMI (>25 kg/m²) (OR=2.45, 95% CI 1.10-5.47, p=0.03), and the presence of underlying medical conditions (OR=1.90, 95% CI 1.02-3.55, p=0.04).
Conclusion: Older age, higher BMI, and underlying medical conditions significantly increased the risk of pregnancy failure in infertile patients undergoing ART. Personalized treatment approaches addressing these risk factors could improve ART outcomes and enhance the chances of successful pregnancies.
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References
Yi H, Yang M, Tang H, Lin M. Risk Factors Of Pregnancy Failure In Infertile Patients Undergoing Assisted Reproductive Technology. Int J Gen Med. 2022;15:8807-17. doi: 10.2147/IJGM.S394236.
Hilbert SM, Gunderson S. Complications Of Assisted Reproductive Technology. Emerg Med Clin North Am. 2019;37(2):239-49. doi: 10.1016/j.emc.2019.01.005.
Sunderam S, Kissin DM, Zhang Y, et al. Assisted Reproductive Technology Surveillance - United States, 2018. MMWR Surveill Summ. 2022;71(4):1-19. doi: 10.15585/mmwr.ss7104a1.
Hu L, Bu Z, Huang G, Sun H, Deng C, Sun Y. Assisted Reproductive Technology In China: Results Generated From Data Reporting System By CSRM From 2013 To 2016. Front Endocrinol (Lausanne). 2020;11:458. doi: 10.3389/fendo.2020.00458.
Cohen AM, Ye XY, Colgan TJ, Greenblatt EM, Chan C. Comparing Endometrial Receptivity Array To Histologic Dating Of The Endometrium In Women With A History Of Implantation Failure. Syst Biol Reprod Med. 2020;66(6):347-54. doi: 10.1080/19396368.2020.1824032.
Hu L, Du J, Lv H, et al. Influencing Factors Of Pregnancy Loss And Survival Probability Of Clinical Pregnancies Conceived Through Assisted Reproductive Technology. Reprod Biol Endocrinol. 2018;16(1):74. doi: 10.1186/s12958-018-0390-6.
Healy M, Patounakis G, Zanelotti A, et al. Does Premature Elevated Progesterone On The Day Of Trigger Increase Spontaneous Abortion Rates In Fresh And Subsequent Frozen Embryo Transfers?. Gynecol Endocrinol. 2017;33(6):472-5. doi: 10.1080/09513590.2017.1291612.
Pontré JC, Ryan JP, Tan A, Hart RJ. The Interval Transfer Of A Frozen-Thawed Embryo Is More Successful Than A Fresh Embryo Transfer For Women Undergoing IVF With Recurrent Implantation Failure After Cleavage Stage Embryo Biopsy. Aust N Z J Obstet Gynaecol. 2019;59(1):134-9. doi: 10.1111/ajo.12798.
He W, Li Q, Yang M, et al. Lower BMI Cutoffs To Define Overweight And Obesity In China. Obesity (Silver Spring). 2015;23(3):684-91. doi: 10.1002/oby.20995.
Peng S, Sun H, Zheng J, Zeng N, Peng F. Risk Factors Of Pregnancy Failure In Elderly Infertility Patients Undergoing Human Assisted Reproductive Technology. Am J Transl Res. 2021;13(6):7306-11. PMID: 34306498.
Guimarães RM, Ribeiro LM, Sasaki LP, Nakagawa HM, Cabral IO. Oocyte Morphology And Reproductive Outcomes - Case Report And Literature Review. JBRA Assist Reprod. 2021;25(3):500-7. doi: 10.5935/1518-0557.20210001.
Franasiak JM, Forman EJ, Hong KH, et al. The Nature Of Aneuploidy With Increasing Age Of The Female Partner: A Review Of 15,169 Consecutive Trophectoderm Biopsies Evaluated With Comprehensive Chromosomal Screening. Fertil Steril. 2014;101(3):656-63.e1. doi: 10.1016/j.fertnstert.2013.11.004.
Wu H, Huang Q, Zhang X, Yu Z, Zhong Z. Analysis Of Genomic Copy Number Variation In Miscarriages During Early And Middle Pregnancy. Front Genet. 2021;12:732419. doi: 10.3389/fgene.2021.732419.
Xiong L, Ye X, Chen Z, et al. Advanced Maternal Age-Associated SIRT1 Deficiency Compromises Trophoblast Epithelial-Mesenchymal Transition Through An Increase In Vimentin Acetylation. Aging Cell. 2021;20(10). doi: 10.1111/acel.13491.
Yang J, Zhang X, Ding X, Wang Y, Huang G, Ye H. Cumulative Live Birth Rates Between GnRH-Agonist Long And GnRH-Antagonist Protocol In One ART Cycle When All Embryos Transferred: Real-World Data Of 18,853 Women From China. Reprod Biol Endocrinol. 2021;19(1):124. doi: 10.1186/s12958-021-00814-0.
Ou J, Xing W, Li Y, Xu Y, Zhou C, Sun QY. Short Versus Long Gonadotropin-Releasing Hormone Analogue Suppression Protocols In IVF/ICSI Cycles In Patients Of Various Age Ranges. PLoS One. 2015;10(7). doi: 10.1371/journal.pone.0133887.
Yi H, Yang M, Tang H, Lin M. Risk Factors of Pregnancy Failure in Infertile Patients Undergoing Assisted Reproductive Technology. International Journal of General Medicine. 2022;15:8807.