Analysis of factors related to early miscarriage after in vitro fertilization embryo transfer

• Main Authors: Liying Zuo (Author), Yuan Fan (Author), Jiajia Ai (Author), Li Tian (Author)
• Format: Book
• Published: BMJ Publishing Group, 2022-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2667-1646; 10.1016/j.gocm.2022.09.001
• Keywords: In vitro fertilization and embryo transfer; Early spontaneous miscarriage; Fresh cycle; Frozen cycle; Gynecology and obstetrics; RG1-991
• Source: Gynecology and Obstetrics Clinical Medicine, Vol 2, Iss 4, Pp 171-174 (2022)

Aims: This research aims to explore the factors related to early spontaneous miscarriage after in vitro fertilization and embryo transfer (IVF-ET) pregnancy, and to provide guidance for improving pregnancy outcomes. Methods: We retrospectively analyzed the data for clinical pregnant women (2591 cycles) undergoing IVF-ET at the reproductive center of Peking University People's Hospital from January 2017 to December 2018; This included 544 ​ET cycles and 2047 frozen embryo transfer cycles. The analysis of factors associated with early miscarriage in the overall population of IVF/intracytoplasmic sperm injection (ICSI) pregnancies (including fresh and thawing cycles) was performed. Results: The risk of early miscarriage in the 35-39 age group was 1.35 times higher than that in the <35 age group (OR ​= ​1.35 [1.05,1.73], p ​= ​0.02). In addition, the risk of early miscarriage was 3.88 times higher in the group ≥40 years old than in the group <35 years old (OR ​= ​3.88 [2.68,5.62], p ​< ​0.001). Endometrial thickness also affected the miscarriage rate; the early miscarriage risk with endometrial thickness ≥8.5 ​mm was 0.78 times than that of the <8.5 ​mm group (OR ​= ​0.78 [0.62,0.98], p ​= ​0.03). The early miscarriage rate during frozen embryo transfer was 1.48 times higher than that during fresh embryo transfer (OR ​= ​1.48 [1.08,2.02], p ​= ​0.01), while in the fresh cycle, the risk of early miscarriage with high-quality embryos was 0.5 times lower than that with non-high quality embryos (OR ​= ​0.5 [0.27,0.9], p ​= ​0.02). In the frozen cycle, the risk of early miscarriage in natural cycle transplantation was 0.73 times that in hormone replacement treatment (HRT) cycle transplantation (OR ​= ​0.73 [0.54,0.97], p ​= ​0.03) . Conclusions: Advanced age is an independent risk factor for early miscarriage, while endometrial thickness at the date of transplantation is an independent protective factor. The risk of early miscarriage in fresh-cycle transplanted embryos is significantly lower than that in frozen embryos, and the number of high-quality embryos in the fresh cycle lowers the miscarriage rate significantly. Natural cycle transplantation has a lower rate of early miscarriage than hormone replacement therapy.