Impact of reproductive history on in vitro fertilization and intracytoplasmic sperm injection outcome: evidence from the German IVF Registry.
OBJECTIVE
To evaluate the effect of reproductive history on the outcome of different procedures in assisted reproductive technologies (ART) comparing IVF, ICSI, and cryopreserved embryo transfer (CPE).


METHODS
Prospective registration of ART cycles and their outcomes.


METHODS
One hundred three reproductive programs in Germany.


METHODS
Women undergoing 174,909 ART procedures from January 1998 through December 2000.


METHODS
Data analysis of reproductive history collected by the German IVF Registry; multiple logistic regression modeling of success rates.


METHODS
Effect of type of conception and outcome of previous pregnancies, duration of infertility, female's age, and type of ART on clinical pregnancy rate per retrieval. Odds ratios with 95% CIs are reported.


RESULTS
More than one previous pregnancy was negatively correlated with outcome of IVF, ICSI, or CPE. This association disappeared when female age was restricted to a maximum of 35 years. A previous pregnancy achieved by spontaneous conception had less impact on outcome of IVF, ICSI or CPE outcome than did a previous assisted conception. Previous live births and miscarriages demonstrated a statistically significant increase compared with ectopic pregnancies and induced abortions.


CONCLUSIONS
Reproductive history must be considered when counseling subfertile couples. Female age, method of conception, and previous pregnancy outcome have a significant effect on IVF, ICSI, and CPE outcome.
Kupka
Markus S
MS
Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. mail@kupka.info
Dorn
Christoph
C
Richter
Oliver
O
Felberbaum
Ricardo
R
van der Ven
Hans
H
D000022:Abortion, Spontaneous; D000293:Adolescent; D000328:Adult; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005858:Germany; D020073:Gravidity; D006801:Humans; D007246:Infertility / Q000503:physiopathology / Q000628:therapy; D008499:Medical Records; D008875:Middle Aged; D009865:Oocytes; D010298:Parity; D011247:Pregnancy; D018873:Pregnancy Rate; D012042:Registries; D012098:Reproduction; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D020858:Tissue and Organ Harvesting