Predictive factors of early pregnancy loss during in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI): retrospective study on 1806 embryo transfers

Abstract

Early pregnancy loss (EPL) is a spontaneous miscarriage of a clinical pregnancy during the first trimester. Several factors of EPL have been studied but results were discordant. We performed a retrospective study in our ART center, comparing baseline data and IVF/ICSI outcomes between cycles with EPL, ongoing pregnancy and without pregnancy. Ectopic pregnancies and biochemical pregnancies (without visualization of a gestational sac on ultrasound) were excluded. The aim of this study is to compare these different cycles, and analyze the risk factors for EPL. We included 2555 IVF/ICSI cycles leading to 2193 oocyte pick-ups and 1806 embryo transfers. Several characteristics (women’s age, infertility diagnosis and duration, estradiol level on the day of hCG-trigger, endometrial thickness, day of embryo transfer) appeared to be risk factors of EPL in univariate analysis. Only women’s age has a significant (p < 0.001) influence in multivariate analysis on the rate of EPL, with an OR: 1.71 if the woman’s age ≥ 35 years old (reference < 35 y.o = 1), 2.96 if ≥ 38 y.o and 5.31 if ≥ 40 y.o. In this study, we observed an increase in EPL rate by 4.15% per year in women over 35 years of age.