Zhongguo quanke yixue (Jan 2022)
Threshold Effect Analysis of Influence of Age on Live Birth Rate in Poor Ovarian Response Patients Treated by Assisted Reproductive Technology
Abstract
BackgroundPregnancy outcome in patients with poor ovarian response (POR) has always been one of the difficult problems in reproductive medicine, but there is few threshold effect analysis of influence of age on live birth rate in POR patients treated by assisted reproductive technology (ART) .ObjectiveTo analyze the threshold effect of influence of age on live birth rate in POR patients treated by ART.MethodsAmong 19 185 women who received routine in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transplantation in Department of Gynaecology and Obstetrics, the First People's Hospital of Shangqiu and Fertility Support Center, the First Affiliated Hospital of Xinjiang Medical University from August 2014 to December 2018, 3 337 patients with POR were selected, and received controlled ovarian stimulation, embryo transplantation by IVF/ICSI and luteal support therapy. The incidence of live birth was analyzed. Univariate and multivariate Logistic analyses were used to analyze the influence of age on live birth in POR patients treated by ART. Moreover, smooth curve fitting and threshold effect analysis were conducted.ResultsOf the 3 337 cases, 1 134 obtained a live birth, the other 2 203 did not, achieving a rate of live birth of 33.98% (1 134/3 337) . Multivariate Logistic analysis result showed that, age was independently associated with live birth in POR patients treated by ART〔OR=0.920, 95%CI (0.902, 0.939) , P<0.01〕. Smooth curve fitting showed that, age was negatively correlated with live birth rate in POR patients treated by ART, but the correlation was not simple linear. Threshold effect analysis results showed that, 32 years old was the threshold for decrease of live birth rate in POR patients treated by ART, namely age did not affect the live birth rate in those ≤32 years old〔OR=1.000, 95%CI (0.998, 1.012) , P=0.38〕, but the live birth rate decreased as age grew in those over 32 years old〔OR=0.800, 95%CI (0.799, 0.823) , P<0.01〕.ConclusionAge was an independent influencing factor of live birth in POR patients treated by ART. The live birth rate may decrease as age grows in these patients over 32 years old.
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