Research question

Is the interval length between an early pregnancy loss and the following treatment cycle a predictor for achieving clinical pregnancy among IVF patients?

Design

This retrospective cohort study of 257 women who reinitiated treatment after first-trimester IVF pregnancy loss was conducted at a tertiary, university-affiliated medical centre between 1 January 2014 to 1 January 2018. Women aged 18–40 years, with normal uterine cavity, who experienced first-trimester pregnancy loss at less than 14 weeks after IVF, were included. Miscarriages were classified as spontaneous, biochemical, medical or surgical.

Results

Among 257 women, interval to subsequent IVF treatment was not associated with achieving pregnancy. Patients after biochemical pregnancy (72.7 ± 56.4, median 60 days) or spontaneous miscarriage (97.7 ± 93.1, median 66 days) had shorter intervals to next cycle, compared with medical (111.9 ± 103.2, median 65 days) or surgical (123.4 ± 111.1, median 84 days) (Kaplan–Meier, P = 0.03) miscarriages.

Logistic regression analysis showed that the chance of subsequent pregnancy was affected by the number of embryos transferred (P = 0.009) and the type of miscarriage. Medical (P = 0.005) and surgical (P = 0.017) miscarriages were related to lower likelihood of pregnancy compared with biochemical pregnancy (reference group).

When pregnancy was achieved in the first post-miscarriage cycle, the chance of live birth increased with shorter intervals (median 57.5 days), whereas second miscarriage was related to longer intervals (median 82.5 days) between miscarriage and subsequent IVF cycle (P = 0.03).

Conclusion

On the basis of this cohort, IVF should not be postponed after pregnancy loss, as shorter intervals were associated with greater likelihood of live birth.

中文翻译：

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早期试管婴儿流产后的受孕：我们应该等待吗？

研究问题

早期流产和下一个治疗周期之间的间隔时间是否是 IVF 患者实现临床妊娠的预测因素？

设计

这项回顾性队列研究于 2014 年 1 月 1 日至 2018 年 1 月 1 日期间在大学附属的三级医疗中心对 257 名在妊娠早期 IVF 流产后重新开始治疗的女性进行。在试管婴儿后不到 14 周内经历了妊娠早期流产的患者也被包括在内。流产分为自然流产、生化流产、药物流产或手术流产。

结果

在 257 名女性中，后续 IVF 治疗的间隔与实现怀孕无关。与药物（111.9 ± 103.2，中位数 65 天）或手术（123.4 ± 111.1 ，中位数 84 天）（Kaplan–Meier，P  = 0.03）流产。

Logistic回归分析显示，移植胚胎的数量（P  =0.009）和流产类型对后续妊娠的机会有影响。 与生化妊娠（参考组）相比，药物流产（P  = 0.005）和手术流产（P = 0.017）与较低的妊娠可能性有关。

当在第一个流产后周期怀孕时，活产的机会随着间隔较短（中位数 57.5 天）而增加，而第二次流产与流产和随后的 IVF 周期之间的较长间隔（中位数 82.5 天）相关（P  = 0.03 ）。

结论

根据该队列，不应在流产后推迟 IVF，因为更短的间隔与更大的活产可能性相关。