Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System.
OBJECTIVE
To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006.


METHODS
Retrospective cohort.


METHODS
Clinic-based data.


METHODS
The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen.


METHODS
None.


METHODS
Clinical intrauterine gestation (presence of gestational sac) and live birth (>or=22 weeks gestation and >or=300 g birth weight).


RESULTS
Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters.


CONCLUSIONS
Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies.
Baker
Valerie L
VL
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California. Electronic address: vlbaker@stanford.edu.
Luke
Barbara
B
Department of Obstetrics, Gynecology, and Reproductive Biology and Department of Epidemiology, Michigan State University, East Lansing, Michigan.
Brown
Morton B
MB
Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Alvero
Ruben
R
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado.
Frattarelli
John L
JL
Advanced Reproductive Medicine and Gynecology of Hawaii, Oahu, Hawaii.
Usadi
Rebecca
R
Carolinas Healthcare, Charlotte, North Carolina.
Grainger
David A
DA
Center for Reproductive Medicine, University of Kansas, Wichita, Kansas.
Armstrong
Alicia Y
AY
Program in Reproductive and Adult Endocrinology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D015331:Cohort Studies; D020964:Embryo Loss / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007256:Information Systems; D050498:Live Birth / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D018873:Pregnancy Rate; D011336:Probability; D012189:Retrospective Studies; D012955:Societies, Medical; D016896:Treatment Outcome; D055815:Young Adult