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- W2753670891 abstract "Short interpregnancy interval (IPI) has been associated with poor maternal and neonatal outcomes in the naturally conceiving population. Patients with a prior live birth from assisted reproductive technology (ART) may want to initiate treatment sooner given a history of infertility, particularly in the setting of advanced maternal age. However, no data exist regarding the interval following delivery that will optimize conception with ART. We aim to determine whether the interval from delivery to initiation of a subsequent treatment cycle (delivery-to-cycle-interval, DCI) is associated with rate of clinical pregnancy or live birth. Retrospective analysis of the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SARTCORS) national cohort. Fresh in vitro fertilization (IVF) cycles following a history of live birth from ART from 2004-2013 were included. DCI was defined as interval from delivery to IVF cycle start. Logistic regression models were fit for prediction of clinical pregnancy (intrauterine gestation by ultrasound) and live birth by DCI with adjustment for age and oocyte source. Predicted probabilities of clinical pregnancy and live birth per cycle start were generated from the logistic model for each DCI category. Pairwise comparisons of outcome probabilities by DCI were made to a reference interval of 12 to <18 months. Of 51,997 IVF cycles following a live birth, 26,973 positive pregnancy tests, 21,141 clinical pregnancies, and 17,536 live births resulted. A DCI <18 months was present in 39.7% of cycles. When compared to a reference DCI of 12 to <18 months, adjusted odds of clinical pregnancy and live birth were significantly decreased at the extremes of DCI, <6 months, 18-24, and >24 months. In a model controlling for maternal age and oocyte source, the predicted probability of clinical pregnancy per cycle start was 5.7% lower for patients with a DCI of <6 months compared to those with DCI of 12 to <18 months (p<0.001). Predicted probability of live birth was 5.1% lower for those with a DCI <6 months compared to those with DCI of 12 to <18 months (p=0.001).Tabled 1Delivery-to-cycle-interval<6 months (n=1,073)6 to <12 months (n=7,085)12 to <18 months (n=12,505) reference18 to <24months (n=10,970)>24 months (n=20,364)p-valueProbability of clinical pregnancy (mean±SE)ab36.7±1.4%c42.2±0.6%42.4±0.4%41.1±0.5%d39.0±0.3%c<0.001Probability of live birth (mean±SE)a30.4±1.4%e34.6±0.5%35.5±0.4%34.2±0.4%f32.3±0.3%c<0.001aPredicted probabilities derived from multivariable logistic regression, adjusting for age and oocyte sourcebIntrauterine gestation by ultrasoundcp<0.001 compared to 12 to <18 months, dp=0.033 compared to 12 to <18 months, ep=0.001 compared to 12 to <18 months, fp=0.035 compared to 12 to <18 months Open table in a new tab aPredicted probabilities derived from multivariable logistic regression, adjusting for age and oocyte source bIntrauterine gestation by ultrasound cp<0.001 compared to 12 to <18 months, dp=0.033 compared to 12 to <18 months, ep=0.001 compared to 12 to <18 months, fp=0.035 compared to 12 to <18 months Patients returning for ART following a live birth should consider targeting a DCI greater than 6 months but less than 18 months to maximize odds of clinical pregnancy and live birth." @default.
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- W2753670891 date "2017-09-01" @default.
- W2753670891 modified "2023-10-07" @default.
- W2753670891 title "Decreased clinical pregnancy and live birth rates after short interval from delivery to subsequent assisted reproduction attempt: an analysis of 51,997 society for assisted reproductive technology (SART) cycles" @default.
- W2753670891 doi "https://doi.org/10.1016/j.fertnstert.2017.07.126" @default.
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