Risk Factors for Different Types of Pregnancy Losses: Analysis of 15,210 Pregnancies After Embryo Transfer

Bibliographic Details
Title: Risk Factors for Different Types of Pregnancy Losses: Analysis of 15,210 Pregnancies After Embryo Transfer
Authors: Ai-Min Yang, Xiuhua Xu, Yan Han, Jian-Jun Wei, Gui-Min Hao, Na Cui, Zhi-Ming Zhao, Wei Wang, Xianghua Huang
Source: Frontiers in Endocrinology, Vol 12 (2021)
Publisher Information: Frontiers Media S.A., 2021.
Publication Year: 2021
Collection: LCC:Diseases of the endocrine glands. Clinical endocrinology
Subject Terms: pregnancy loss, frozen-thawed embryo transfer, polycystic ovary syndrome, thickness of endometrium, obesity, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
More Details: ObjectiveTo evaluate the risk factors for different types of pregnancy losses after embryo transfer (ET).DesignRetrospective cohort study.SettingReproductive medicine center.ParticipantsA total of 15,210 pregnancies after fresh and frozen-thawed embryo transfer between January 2014 and June 2019.Main Outcome MeasuresThe primary outcome was pregnancy loss (PL) throughout the entire pregnancy. Secondary outcomes were non-visualized PL, early miscarriage, late miscarriage, and stillbirth.MethodsThe effect of patients’ baseline characteristics and IVF/ICSI cycle-specific factors on the risk of PL after fresh and frozen-thawed ET was determined by multivariate logistic regression analysis.ResultsCompared to women under 35 years old, those between 35 and 40 had an increased risk of early miscarriage [odds ratio (OR) 1.49, 95% confidence interval (CI) 1.22-1.83], while those after 40 appeared to have an increased risk of both early miscarriage (OR 3.82, 95% CI 2.65-5.51) and late miscarriage (OR 2.79, 95% CI 1.64-4.77). Overweight patients were observed to have a higher risk of late miscarriage (OR 1.38, 95% CI 1.16-1.65), while obese patients showed a higher risk of both early miscarriage (OR 1.47, 95% CI 1.14-1.91) and late miscarriage (OR 1.80, 95% CI 1.33-2.44). Polycystic ovary syndrome (PCOS) was an independent risk factor for late miscarriage (OR 1.58, 95% CI 1.28-1.96), and the detrimental effect of PCOS was independent of obesity status. Women with uterine factors had a higher risk of early miscarriage (OR 1.77 (95% CI 1.32-2.38) than women without uterine factors. A negative correlation was observed between the thickness of the endometrium and PL (OR 0.95 95% CI 0.92-0.97). There was an increased risk of PL after frozen-thawed ET versus fresh ET (OR 1.12, 95% CI 1.01-1.24). Women who transferred ≥2 embryos showed lower risk of overall PL than women who transferred a single embryo, with adjusted ORs ranged from 0.57~0.94. However, women who transferred three embryos demonstrated a higher risk of late miscarriage than women who transferred a single embryo (OR 2.23, 95% CI 1.36-3.66).ConclusionsPatients with uterine factors demonstrated higher risk of early miscarriage and stillbirth. Being overweight, PCOS, and transferring three embryos was associated with late miscarriage. Being aged 40 and over, obese, and using frozen embryo transfer was associated with early and late miscarriage.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1664-2392
Relation: https://www.frontiersin.org/articles/10.3389/fendo.2021.683236/full; https://doaj.org/toc/1664-2392
DOI: 10.3389/fendo.2021.683236
Access URL: https://doaj.org/article/bd1b0acf20d94b19962349003a001579
Accession Number: edsdoj.bd1b0acf20d94b19962349003a001579
Database: Directory of Open Access Journals
More Details
ISSN:16642392
DOI:10.3389/fendo.2021.683236
Published in:Frontiers in Endocrinology
Language:English