A multifactorial analysis of in vitro fertilization outcomes.

ABSTRACT: Outcomes of in vitro fertilization (IVF) are woven by a complex interplay of multiple factors. Identifying how various variables correlate with the outcome of each step during the IVF procedure can inform on the overall success of the procedure. We studied 1,736 non-donor IVF cycles at our fertility center to evaluate associations between maternal age, body mass index (BMI), anti-Müllerian hormone (AMH) level, and antral follicle count (AFC) with the overall success of IVF in the first cycle, subsequent cycles, and all cycles, defined in terms of oocytes retrieved, oocyte maturation rate, fertilization rate, and live birth. The results indicated that maternal age was the strongest factor in IVF success with live birth rate of 57, 41, and 53% in the first cycle, subsequent cycles, and all cycles, respectively, in women < 35 years, and 27, 16, and 22% in the first cycle, subsequent cycles, and all cycles, respectively, in women 41-42 years old. AMH levels and AFC were strongly associated with oocyte retrieval and blastocyst formation but were less associated with the live birth. The number of mature oocytes and oocyte maturation rates were significantly associated with live birth. BMI did not show a significant correlation with oocyte yield and embryo development except in extremely obese patients. These findings support the use of individualized treatment strategies and development of predictive modeling based on biological markers to optimize IVF success.

LAY SUMMARY: This study analyzed the data collected from the patients undergoing IVF to investigate the association between maternal age, anti-Müllerian hormone (AMH) - a protein hormone produced by the cells surrounding the developing eggs - levels, antral follicle count (AFC) - a measure of ovarian reserve or potential fertility, and BMI, and key reproductive outcomes including retrieved eggs, maturation rate, embryo development rate, and live birth. An analysis of multiple factors and IVF outcomes showed that maternal age remains the most significant factor of the IVF success. Although AMH and AFC are strong markers of ovarian response, their association with live birth is limited. Additionally, BMI did not show a significant impact on the outcomes.