Live birth rates of assisted reproductive technology treatment and spontaneous conception among subfertile couples in Singapore: A follow-up study

• Main Authors: Ho Lee Mee, de Souza Nurun Nisa, Lee Shaw Ni, Yu Su Ling
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Asian Pacific Journal of Reproduction
• Subjects: Assisted reproductive technology; Semen parameters; Sperm hyaluronan-binding assay; Spontaneous conception; Subfertile Asian couples
• Online Access: http://www.apjr.net/article.asp?issn=2305-0500;year=2018;volume=7;issue=5;spage=206;epage=213;aulast=Mee

Objective: To explore the potential predictors of a live birth (LB) outcome among subfertile couples of Asian ethnicity undergoing the first fertility treatment cycle; to assess the cumulative live birth rates after successive cycles; and to determine the incidence rate of spontaneous conception (SC). Methods: Subfertile couples were grouped according to treatment modalities at the first fertility treatment cycle: intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and no treatment, and were followed-up for duration up to seven years. Multivariable logistic regression analysis was used for statistical analyses. Results: Age of female subjects [35-38 years, odds ratio (OR): 0.39; ≥ 39 years, OR: 0.14], uterine factor subfertility (OR: 5.24), and treatment modalities (ORs: IUI 0.25, IVF 2.33 and ICSI 1.91) significantly predicted a LB outcome (P<0.05). The cumulative live birth rates were 11.7% IUI, 41.5% IVF, 27.5% ICSI and 22.6% from frozen embryo transfer cycles. The cumulative SC rate was 24.6% in the non-treated group and 10.7% in the treated group. All LBs from IVF cycles were delivered by the second cycle and within four years, compared to SC delivery of within five years in the non-treated group and six years in the treated group. Conclusions: Age of female subject, uterine factor and modalities of treatment are significant predictors for LB outcome at the first cycle. Higher delivery rates could be achieved following fewer successive IVF cycles and within a shorter duration compared to SC.