Background
Methods
Statistical methods
Results
Demographics and clinical characteristics of clinical pregnancies
Variables | Total | Nanjing | Changzhou |
P
|
---|---|---|---|---|
Total number | 5485 | 4165 | 1320 | |
Maternal age | 30.01 ± 4.03 | 29.89 ± 4.03 | 30.42 ± 4.03 |
<0.001
*
|
Maternal BMI | 22.08 ± 3.03 | 22.04 ± 2.99 | 22.21 ± 3.16 | 0.227 |
Paternal BMI | 24.23 ± 3.09 | 24.18 ± 2.98 | 24.37 ± 3.39 | 0.131 |
Infertility type | 0.593 | |||
Primary | 2781(53.0%) | 2165(52.8%) | 616(53.7%) | |
Secondary | 2466(47.0%) | 1935(47.2%) | 531(46.3%) | |
COH protocol |
<0.001
*
| |||
GnRH-a long protocol | 3406(63.1%) | 2311(56.7%) | 1095(83.0%) | |
GnRH-a short protocol | 1573(29.2%) | 1448(35.5%) | 125(9.5%) | |
GnRH antagonist protocol | 95(1.8%) | 95(2.3%) | 0(0.0%) | |
Minimal stimulation protocol | 186(3.4%) | 111(2.7%) | 75(5.7%) | |
GnRH-a rolonged protocol | 123(2.3%) | 108(2.6%) | 15(1.1%) | |
Other protocol | 13(0.2%) | 4(0.1%) | 9(0.7%) | |
Total Gn dose | 1808.01 ± 662.11 | 1833.67 ± 613.50 | 1728.88 ± 788.45 |
<0.001
*
|
Groups of total Gn dose |
<0.001
*
| |||
< 1808.01 | 3181(59.0%) | 2344(57.6%) | 837(63.4%) | |
≥ 1808.01 | 2208(41.0%) | 1725(42.4%) | 483(36.6%) | |
Fertilization methods |
<0.001
*
| |||
IVF | 4543(83.9%) | 3641(88.8%) | 902(68.3%) | |
ICSI | 875(16.1%) | 457(11.2%) | 418(31.7%) | |
Cycle type |
<0.001
*
| |||
Fresh | 2675(51.9%) | 2202(57.5%) | 473(35.8%) | |
Frozen | 2477(48.1%) | 1630(42.5%) | 847(64.2%) | |
No. of embryos transferred |
<0.001
*
| |||
1 | 474(8.7%) | 442(10.7%) | 32(2.4%) | |
2 | 4324(79.6%) | 3088(75.0%) | 1236(93.6%) | |
3 | 655(11.5%) | 585(14.2%) | 52(3.9%) | |
Cleavage-stage embryo or blastocyst | ||||
Cleavage-stage embryo | 3860(73.3%) | 2540(64.4%) | 1320(100.0%) | |
Blastocyst | 1405(26.7%) | 1405(35.6%) | 0(0.0%) | |
Serum hCG levels 14 days after transfer | 695.30 ± 515.44 | 619.49 ± 470.08 | 861.75 ± 568.97 |
<0.001
*
|
Groups of serum hCG levels 14 days after transfer |
<0.001
*
| |||
< 695.30 | 2205(52.2%) | 1598(55.5%) | 607(46.3%) | |
≥ 695.30 | 1988(47.8%) | 1283(44.5%) | 705(53.7%) |
Factors influencing live birth probability throughout gestational weeks
Variables | No. of PL/total (685/ 5485) | PL rate | HR (95% CI)a |
P
a
|
---|---|---|---|---|
Maternal age | ||||
< 30 | 292/2556 | 11.4% | 1.00[Reference] | |
30–35 | 283/2361 | 12.0% | 1.06(0.90–1.25) | 0.508 |
36–40 | 84/472 | 17.8% | 1.63(1.28–2.08) |
<0.001
*
|
> 40 | 20/53 | 37.7% | 4.14(2.63–6.52) |
<0.001
*
|
Ptrend | 1.31(1.17–1.45) |
<0.001
*
| ||
Maternal BMI | ||||
< 18.5 | 50/509 | 9.8% | 0.85(0.63–1.13) | 0.260 |
18.5–25 | 487/4009 | 12.1% | 1.00[Reference] | |
25–28 | 97/641 | 15.1% | 1.24(1.00–1.55) | 0.051 |
≥ 28 | 42/235 | 17.9% | 1.52(1.11–2.10) |
0.010
*
|
Paternal BMI | ||||
< 18.5 | 9/103 | 8.7% | 0.67(0.33–1.35) | 0.264 |
18.5–25 | 405/3309 | 12.2% | 1.00[Reference] | |
25–28 | 189/1344 | 14.1% | 1.15(0.96–1.37) | 0.120 |
≥ 28 | 69/603 | 12.3% | 0.95(0.74–1.23) | 0.691 |
Infertility type | ||||
Primary | 337/2781 | 12.1% | 1.00[Reference] | |
Secondary | 319/2466 | 12.9% | 0.99(0.85–1.16) | 0.908 |
COH protocold | ||||
GnRH-a long protocol | 391/3406 | 11.5% | 1.00[Reference] | |
GnRH-a short protocol | 186/1573 | 11.8% | 0.93(0.77–1.11) | 0.373 |
GnRH antagonist protocol | 35/95 | 36.8% | 3.49(2.46–4.94) |
<0.001
*
|
Minimal stimulation protocol | 44/186 | 23.7% | 1.83(1.31–2.54) |
<0.001
*
|
GnRH-a rolonged protocol | 12/123 | 9.8% | 0.84(0.48–1.50) | 0.689 |
Other protocol | 5/13 | 38.5% | 3.70(1.53–8.95) |
0.004
*
|
The total Gn doseb | ||||
< 1808.01 | 373/3181 | 11.7% | 1.00[Reference] | |
≥ 1808.01 | 301/2208 | 13.6% | 1.12(0.96–1.30) | 0.161 |
Fertilization methods | ||||
IVF | 579/4543 | 12.7% | 1.00[Reference] | |
ICSI | 98/875 | 11.2% | 0.87(0.70–1.08) | 0.205 |
Cycle type | ||||
Fresh | 282/2675 | 10.5% | 1.00[Reference] | |
Frozen | 337/2477 | 13.6% | 1.30(1.11–1.53) |
0.001
*
|
No. of embryos transferred | ||||
1 | 82/474 | 17.3% | 1.00[Reference] | |
2 | 516/4324 | 11.9% | 0.71(0.56–0.90) |
0.005
*
|
3 | 84/637 | 13.2% | 0.67(0.49–0.91) |
0.010
*
|
Ptrend | 0.81(0.69–0.96) |
0.012
*
| ||
Cleavage-stage embryo or blastocystd | ||||
Cleavage-stage embryo | 466/3860 | 12.1% | 1.00[Reference] | |
Blastocyst | 198/1405 | 14.1% | 1.10(1.01–1.19) |
0.030
*
|
Serum hCG levels 14 days after transferc | ||||
< 695.30 | 334/2205 | 15.1% | 1.00[Reference] | |
≥ 695.30 | 115/1988 | 5.8% | 0.36(0.29–0.45) |
<0.001
*
|
Variables | βa | SEb |
HR
| 95% CI |
P
|
---|---|---|---|---|---|
Maternal age (reference: <30) | |||||
30–35 | 0.0733 | 0.1102 | 1.08 | 0.87–1.34 | 0.506 |
36–40 | 0.3758 | 0.1697 | 1.46 | 1.04–2.03 |
0.027
*
|
> 40 | 1.1000 | 0.3222 | 3.00 | 1.60–5.65 |
<0.001
*
|
COH protocol (reference: GnRH-a long protocol) | |||||
GnRH-a short protocol | 0.0326 | 0.1191 | 1.03 | 0.82–1.30 | 0.784 |
GnRH antagonist protocol | 0.8914 | 0.2698 | 2.44 | 1.44–4.14 |
<0.001
*
|
Minimal stimulation protocol | 0.7869 | 0.2152 | 2.20 | 1.44–3.35 |
<0.001
*
|
GnRH-a rolonged protocol | −0.1192 | 0.4160 | 0.89 | 0.39–2.01 | 0.774 |
Other protocol | 1.3692 | 0.5070 | 3.93 | 1.46–10.62 |
0.007
*
|
Cycle Type (reference: Fresh) | |||||
Frozen | 0.2296 | 0.1057 | 1.26 | 1.02–1.55 |
0.030
*
|
Serum hCG levels 14 days after transfer (reference: < 695.30) | |||||
≥ 695.30 | −1.0848 | 0.1180 | 0.34 | 0.27–0.43 |
<0.001
*
|
Risk factors for early miscarriage and late miscarriage
Variables | Early miscarriage | Late miscarriage | ||||||
---|---|---|---|---|---|---|---|---|
Nc (%) | n (%) | HR (95%CI)a |
P
a
| Nd (%) | n (%) | HR (95%CI)a |
P
a
| |
Maternal age | ||||||||
< 30 | 2556(47.0) | 180(39.5) | 1.00 | 2376(47.7) | 94(49.7) | 1.00 | ||
30–35 | 2361(43.4) | 188(41.2) | 1.14(0.93–1.40) | 0.215 | 2173(43.6) | 80(42.3) | 0.93(0.69–1.25) | 0.630 |
36–40 | 472(8.7) | 69(15.1) | 2.14(1.62–2.83) |
<0.001
*
| 403(8.1) | 15(7.9) | 0.94(0.54–1.62) | 0.823 |
> 40 | 53(1.0) | 19(4.2) | 6.04(3.76–9.69) |
<0.001
*
| 34(0.7) | 0(0.0) | 0 | 0.992 |
Maternal BMI | ||||||||
< 18.5 | 509(9.4) | 32(7.0) | 0.82(0.57–1.18) | 0.282 | 477(9.7) | 15(8.1) | 0.82(0.52–1.51) | 0.647 |
18.5–25 | 4009(74.3) | 335(73.3) | 1.00 | 3674(74.4) | 130(70.3) | 1.00 | ||
25–28 | 641(11.9) | 65(14.2) | 1.19(0.91–1.55) | 0.205 | 576(11.7) | 24(13.0) | 1.20(0.78–1.86) | 0.407 |
≥28 | 235(4.4) | 25(5.5) | 1.35(0.90–2.03) | 0.145 | 210(4.3) | 16(8.6) | 2.09(1.22–3.57) |
0.007
*
|
Paternal BMI | ||||||||
< 18.5 | 103(1.9) | 8(1.8) | 1.07(0.53–2.16) | 0.859 | 95(1.9) | 1(0.5) | 0.00(0.00 − +∞) | 0.992 |
18.5–25 | 3309(61.7) | 266(58.6) | 1.00 | 3043(62.0) | 120(64.9) | 1.00 | ||
25–28 | 1344(25.1) | 129(28.4) | 1.17(0.95–1.45) | 0.137 | 1215(24.8) | 50(27.0) | 1.06(0.76–1.48) | 0.728 |
≥ 28 | 603(11.3) | 51(11.2) | 1.08(0.80–1.46) | 0.616 | 552(11.3) | 14(7.6) | 0.64(0.37–1.12) | 0.118 |
Infertility type | ||||||||
Primary | 2781(53.0) | 227(51.1) | 1.00 | 2554(53.2) | 92(51.7) | 1.00 | ||
Secondary | 2466(47.0) | 217(48.9) | 0.94(0.78–1.14) | 0.544 | 2249(46.8) | 86(48.3) | 1.10(0.81–1.49) | 0.538 |
COH protocolb | ||||||||
GnRH-a long protocol | 3406(63.1) | 243(53.4) | 1.00 | 3163(64.0) | 125(67.9) | 1.00 | ||
GnRH-a short protocol | 1573(29.2) | 132(29.0) | 1.00(0.80–1.26) | 0.974 | 1441(29.2) | 48(26.1) | 0.85(0.60–1.21) | 0.370 |
GnRH antagonist protocol | 95(1.8) | 29(6.4) | 4.11(2.78–6.08) |
<0.001
*
| 66(1.3) | 5(2.7) | 1.95(0.80–4.78) | 0.144 |
Minimal stimulation protocol | 186(3.4) | 40(8.8) | 2.39(1.67–3.43) |
<0.001
*
| 146(3.0) | 1(0.5) | 0.18(0.02–1.29) | 0.088 |
GnRH-a rolonged protocol | 123(2.3) | 8(1.8) | 0.90(0.44–1.82) | 0.765 | 115(2.3) | 3(1.6) | 0.67(0.21–2.11) | 0.492 |
Other protocol | 13(0.2) | 3(0.7) | 3.27(1.04–10.23) |
0.042
*
| 10(0.2) | 2(1.1) | 5.52(1.36–22.40) |
0.017
*
|
The total Gn dose | ||||||||
< 1808.01 | 3181(59.0) | 252(55.4) | 1.00 | 2929(59.4) | 104(56.2) | 1.00 | ||
≥ 1808.01 | 2208(41.0) | 203(44.6) | 1.08(0.89–1.30) | 0.440 | 2005(40.6) | 81(43.8) | 1.15(0.86–1.54) | 0.355 |
Fertilization methods | ||||||||
IVF | 4543(83.9) | 386(84.6) | 1.00 | 4157(83.8) | 162(86.6) | 1.00 | ||
ICSI | 875(16.1) | 70(15.4) | 0.93(0.72–1.20) | 0.562 | 805(16.2) | 25(13.4) | 0.81(0.53–1.23) | 0.320 |
Cycle type | ||||||||
Fresh | 2675(51.9) | 161(39.1) | 1.00 | 2514(53.0) | 106(60.6) | 1.00 | ||
Frozen | 2477(48.1) | 251(60.9) | 1.67(1.37–2.04) |
<0.001
*
| 2226(47.0) | 69(39.4) | 0.73(0.54–0.99) |
0.045
*
|
No. of embryos transferred | ||||||||
1 | 474(8.7) | 64(14.0) | 1.00 | 410(8.2) | 16(8.4) | 1.00 | ||
2 | 4324(79.6) | 330(72.1) | 0.61(0.47–0.80) |
<0.001
*
| 3994(80.2) | 157(82.6) | 0.99(0.59–1.65) | 0.961 |
3 | 637(11.7) | 64(14.0) | 0.63(0.44–0.89) |
0.010
*
| 573(11.5) | 17(8.9) | 0.75(0.38–1.51) | 0.425 |
Cleavage-stage embryo or blastocystb | ||||||||
Cleavage-stage embryo | 3860(73.3) | 305(68.2) | 1.00 | 3555(73.8) | 135(73.8) | 1.00 | ||
Blastocyst | 1405(26.7) | 142(31.8) | 1.15(1.04–1.27) |
0.006
*
| 1263(26.2) | 48(26.2) | 1.00(0.85–1.18) | 0.994 |
Serum hCG levels 14 days after transfer | ||||||||
< 695.30 | 2187(52.2) | 248(82.7) | 1.00 | 1939(49.8) | 79(59.8) | 1.00 | ||
≥ 695.30 | 2006(47.8) | 52(17.3) | 0.22(0.16–0.30) |
<0.001
*
| 1954(50.2) | 53(40.2) | 0.68(0.48–0.96) |
0.030
*
|
Variables | βa | SEb |
HR
| 95% CI |
P
|
---|---|---|---|---|---|
Maternal age (reference: <30) | |||||
30–35 | 0.1196 | 0.1392 | 1.13 | 0.86–1.48 | 0.390 |
36–40 | 0.5253 | 0.1956 | 1.69 | 1.15–2.48 |
0.007
*
|
> 40 | 1.3087 | 0.3324 | 3.70 | 1.93–7.10 |
<0.001
*
|
COH protocol (reference: GnRH-a long protocol) | |||||
GnRH-a short protocol | 0.2526 | 0.1460 | 1.29 | 0.97–1.71 | 0.084 |
GnRH antagonist protocol | 1.2436 | 0.2953 | 3.47 | 1.94–6.19 |
<0.001
*
|
Minimal stimulation protocol | 1.1429 | 0.2310 | 3.14 | 2.00–4.93 |
<0.001
*
|
GnRH-a rolonged protocol | 0.0747 | 0.5109 | 1.08 | 0.40–2.93 | 0.884 |
Other protocol | 1.4356 | 0.5868 | 4.20 | 1.33–13.27 |
0.014
*
|
Cycle Type (reference: Fresh) | |||||
Frozen | 0.5059 | 0.1287 | 1.66 | 1.29–2.13 |
<0.001
*
|
Serum hCG levels 14 days after transfer (reference: < 695.30) | |||||
≥ 695.30 | −1.6353 | 0.1687 | 0.19 | 0.14–0.27 |
<0.001
*
|