Die Voraussage über den Erfolg einer IVF-ET-Behandlung durch Kombination vier verschiedener Prognosefaktoren

Zusammenfassung

Fragestellung

Die Betrachtung der Kombination Endometriumdicke, Embryoscore, Alter und Hydrosalpinx als Prognosekriterien für den Erfolg einer IVF-ET-Behandlung.

Material und Methodik

Es wurden insgesamt 562 Patientinnen prospektiv in die Studie eingeschlossen. Basierend auf den vier Prognosefaktoren: Alter, Endometriumdicke, Embryoqualität und bestehende Hydrosalpinx (ein- oder beidseits) wurden diese Patientinnen in drei Gruppen unterteilt („plus“, „plus/minus“, „minus“). Die „plus“-Gruppe (n = 350) schloss Patientinnen mit 40 Jahren und darunter ein, ohne nachgewiesener Hydrosalpinx mit einer Endometriumdicke ≥ 9 mm und einem Embryoscore von vier [[24]]. Die „plus/minus“-Gruppe (n = 177) umfasste Patientinnen, die eines dieser vier Kriterien nicht erfüllten. Patientinnen in der „minus“ Gruppe (n = 35) erfüllten zwei oder mehr dieser Kriterien nicht.

Ergebnisse

Von 350 Patientinnen, die als prognostisch gut eingestuft waren, wurden 41,4 % schwanger, 177 Patientinnen mit einer mittelmäßigen Prognose (n = 177) zeigten eine Schwangerschaftsrate (SSR) von 20,7 %, wogegen Patientinnen mit einer ungünstigen Prognose (n = 35) nur zu 5,7 % schwanger wurden (p = 0,0001).

Schlussfolgerung

Die erzielten Ergebnisse lassen den Schluss zu, dass die Aufstellung und Auswertung jener Prognosekriterien für den Erfolg einer IVF-ET-Behandlung relevant sind.

Summary

Objective

We analyzed whether the outcome of in vitro fertilization and embryo transfer (IVF-ET) could be predicted on the basis of age, endometrial thickness, embryo quality, and tubal status.

Methods

We prospectively analyzed the outcome of IVF-ET in 562 women according to age (≤ 40 vs. > 40 years), endometrial thickness (< 9 vs. ≥ 9 mm), embryo quality (embryo score 4 vs. < 4), and tubal status (presence or absence of hydrosalpinx). Patients were categorized into three groups. The favorable group comprised 350 women ≤ 40 years, with no hydrosalpinx, endometrial thickness ≥ 9 mm, and an embryo score of 4. The intermediate group comprised 177 women who did not fulfill one of these four criteria and the unfavorable group 35 women who did not meet two or more of the criteria. Implantation rates per transferred embryo, pregnancy rates, multiple pregnancy rates, endometrial thickness, abnormal oocytes, number of oocytes obtained for ET and freezing, number of retrieved oocytes, highest grade embryo for transfer, mean age, and levels of estradiol, FSH and LH at baseline were noted.

Results

The implantation rates in the three groups were 18 %, 4.9 % and 0.7 %, respectively (p = 0.0001). The total pregnancy rates were 41 %, 21 % and 5.7 % (p = 0.0001) and the ongoing pregnancy rates were 35 %, 11 % and 0.7 %, respectively.

Conclusion

These results suggest that age, endometrial thickness, tubal status, and embryo quality are relevant to the outcome of IVF-ET.

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