Effect of the interpregnancy interval after early pregnancy loss on pregnancy outcomes after subsequent embryo transfer: a retrospective cohort study

早期妊娠丢失后两次妊娠间隔对后续胚胎移植妊娠结局的影响:一项回顾性队列研究

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Abstract

BACKGROUND: After early pregnancy loss (EPL), couples often seek counselling on how long to wait before attempting to conceive again. However, the optimal interpregnancy interval (IPI) between EPL and the next pregnancy is controversial. Additionally, studies on the impact of the IPI following a previous EPL on the population with infertility are rare. Here, we explore the relationship between the IPI after EPL and pregnancy outcomes after subsequent frozen embryo transfer (FET). METHODS: In total, 859 patients were included in this retrospective study. Among these, 87 women (10.1%) had an IPI of less than 3 months, 402 (46.8%) had an IPI of 3 to 6 months, 279 (32.5%) had an IPI of 6 to 12 months, and 91 (10.6%) had an IPI of more than 12 months. The baseline characteristics of the four groups were compared and analyzed. Binary logistic regression analyses were subsequently conducted to investigate the association between the IPIs after EPL and pregnancy outcomes after subsequent FET. RESULTS: The live birth rates of the four groups were 41.4%, 41.5%, 36.9% and 28.6%, respectively. There were no significant differences in live birth, biochemical pregnancy, clinical pregnancy, clinical pregnancy loss, or preterm birth among the four groups (P > 0.05). The results of the logistic regression analyses revealed that compared with an IPI of 3 to 6 months, a shorter IPI (1∼3 months) was not associated with decreased odds of live birth (adjusted OR, 1.001 [0.61-1.63]), biochemical pregnancy (adjusted OR, 0.95 [0.58-1.54]), or clinical pregnancy (adjusted OR, 0.96 [0.59-1.55]), and was not associated with an increased risk of clinical pregnancy loss (adjusted OR, 0.90 [0.41-1.97]) or preterm birth (adjusted OR, 0.87 [0.28-2.67]). However, compared with an IPI of 3 to 6 months, a longer IPI (≥ 12 months) was associated with reduced odds of a live birth (adjusted OR, 0.55 [0.32-0.93]). CONCLUSIONS: The results of this study suggest that a short IPI following the return of menstruation did not appear to be significantly associated with adverse pregnancy outcomes. However, prolonging the IPI beyond 12 months might correlate with a reduced likelihood of achieving a live birth, although further research is needed to confirm this observation.

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