To investigate the effect of the embryo accumulation strategy prior to embryo transfer on reproductive outcomes among advanced-age women undergoing IVF/ICSI treatment.
Approach:
Study Design: Retrospective cohort study involving 970 advanced-age female patients undergoing IVF/ICSI treatment.
Groups: Participants were divided into an embryo accumulation group (325 patients) and a control group (645 patients).
Matching: 1:1 propensity score matching was applied, resulting in 299 matched pairs (598 patients).
Analysis: Multivariable logistic regression models assessed the independent effect of embryo accumulation on pregnancy outcomes.
Key Findings:
After PSM, the biochemical pregnancy rate, cumulative live birth rate (CLBR), and cumulative clinical pregnancy rate (CCPR) were significantly higher in the embryo accumulation group (P < 0.001).
No significant difference in miscarriage rates between the two groups (P = 0.583).
Embryo accumulation correlated with increased CLBR (OR = 2.75, 95% CI: 1.87–4.05, P < 0.001) and CCPR (OR = 2.71, 95% CI: 1.87–3.92, P < 0.001).
CLBR and CCPR increased with cumulative embryo number when ≤ 2 (P 2.
Interpretation:
Embryo accumulation via consecutive stimulation cycles can improve reproductive outcomes in advanced-age women undergoing IVF/ICSI, particularly when the number of accumulated embryos does not exceed two.
Limitations:
Retrospective study design may introduce unadjusted confounding factors.
Individualized treatment strategies should consider age, physical status, and economic conditions.
Conclusion:
Embryo accumulation can optimize reproductive outcomes for advanced-age women undergoing assisted reproductive technology.
