scholarly journals Effect of Female Age on Infertility Diagnostic Factors and In-vitro Fertilization Treatment Outcomes: A Single-center Retrospective Cohort Study

2021 ◽  
Author(s):  
Zhouxuan Li ◽  
Songyuan Tang ◽  
Shan Liu ◽  
Huan Xu ◽  
Zhen Lei ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Retrospective Cohort ◽  
Maternal Age ◽  
Age Groups ◽  
Economic Cost ◽  
Advanced Age ◽  
Oocyte Number ◽  
Second Child ◽  
Child Policy ◽  
Embryo Number

AbstractBackgroundInfertility has become an important issue in modern world because of the increasing number of infertile couples around the world. Advanced maternal age was considered to be a main factor of infertile problem. With second child policy published in China and more women in China intend to seek help for infertility problem, this study provided information of fertility diagnostic factors and IVF treatment outcomes of female IVF patients in different age groups, which can be a guidance for infertility diagnostic and treatment.MethodsA retrospective cohort study was conducted to IVF patient data collected by Jinjiang District Maternal and Child Health Hospital, Chengdu, China. Clinical and laboratory data of 45,743 fresh, autologous IVF cycles from January 2008 to September 2017 were included in the analysis. The diagnostic factors and treatment outcomes were analyzed for different age groups (age<35, n=30,708; age 35-41, n=11,921 and age≥42, n=3,114) as well as further stratified advanced age groups (age 42, n=933; age 43, n=744; age 44, n=556; age≥45, n=881). The characteristics including number of previous cycles, duration of infertility, BMI, basic FSH, basic AFC, AMH, retrieved oocyte number, fertilized oocyte number, transferred embryo number, baby number and economic cost were stratified according to patient age.ResultsThe basic characteristics of obesity rate, basic FSH and cancellation rate of IVF cycles in ≥42 years old group were significantly higher than other groups (p<0.01). Basic AFC, AMH, retrieved oocyte number, fertilized oocyte number and transferred embryo number in ≥42 years old group were significantly lower than other groups (p<0.01). Diagnostics characteristics and IVF-ET outcome declined significantly when maternal age increased (p<0.05). In the meanwhile, a preliminary analysis of cost per cycle showed that cost per child increased with patient’s age increase.ConclusionAlthough with increasing number of advanced maternal age IVF cycles, the age group of ≥42 years would intend to get unsatisfied outcome and higher cost per child. More guidance and considerations should be focused on encouraging earlier age treatment of infertility.Plain English summaryWith more and more women in the global range choose to get late pregnancy because of changes in society and economy, age has become an unavoidable factor in infertility diagnostic and treatment. Advanced age women may experience more infertility problems and negative IVF outcomes. A better understanding of the effect of maternal age on infertility would offer help to both diagnostic and treatment of IVF patient. This study conducted a single-center retrospective cohort analysis to female patients of different age groups and found that women with more advanced age (≥42) would be more easily to experience unsatisfied IVF outcome and higher economic cost to obtain one child. After the publication of second child policy in China in 2013, the number of advanced age patients increased, the necessity of special guidance for AMA patient may need to be taken into consideration.

scholarly journals The Correlation between Maternal Age and Fetal Sex Chromosome Aneuploidies: A 8-year Single Institution Experience in China

2020 ◽  
Author(s):  
Li Hongge ◽  
Jinglei Jin
Keyword(s):  
Odds Ratio ◽  
Maternal Age ◽  
Sex Chromosome ◽  
Age Groups ◽  
University Teaching ◽  
Advanced Age ◽  
Chi Square ◽  
Fetal Sex ◽  
Chi Square Test ◽  
Sex Chromosome Aneuploidies

Abstract Background: Although a few studies have investigated the association between maternal age and fetal sex chromosome aneuploidies (SCAs), most of these studies were limited to advanced age women and the results were conflicting. This study aimed to investigate maternal age-specific rates for common fetal SCAs (including 45,X, 47,XXY, 47,XXX and 47,XYY) in pregnant women of different ages that not only limited to advanced age women. We retrospectively investigated a 8-year experience of prenatal diagnosis for fetal chromosome aberrations by second-trimester amniocentesis at a university teaching hospital in China. 20,409 amniotic fluid specimens collected at 19–22+6 gestational weeks were included in this study. The women were categorized into five age groups (≤23, 24-28, 29-33, 34-38, 39+ years) based on maternal age at the time of amniocentesis and entered as a categorical variable in all samples. The correlation between fetal SCAs and maternal age was determined using the logistic regression analysis. A chi-square test was performed to compare the incidence of fetal SCAs among age groups. Results: A total of 179 cases of fetal SCAs were detected, and the incidence was 8.77‰ (about 1/114). The incidence of all SCAs increased significantly with advancing maternal age (SE, 0.014; odds ratio, 1.044; P=0.002), from 5.81 per 1,000 fetuses at the 24-28 years to 10.92 per 1,000 at the 39+ years. The incidence of all SCAs was also significantly different among age groups (χ2=10.197, P=0.037<0.05). Specifically, the incidence of 45,X (SE, 0.037; odds ratio, 0.916; P=0.017) and 47,XXY (SE, 0.024; odds ratio, 1.127; P=0.000) had significant correlation with maternal age, while the incidence of 47,XXX and 47,XYY had no correlation with maternal age (P=0.473; P=0.272, respectively). Conclusions: Maternal age was ascertained to be a strong risk factor for fetal SCAs.

Status and Determinants of Treatment Outcomes Among New Tuberculosis Patients in South Korea: A Retrospective Cohort Study

2021 ◽  
pp. 101053952110005
Author(s):  
Hyunjin Son ◽  
Jeongha Mok ◽  
Miyoung Lee ◽  
Wonseo Park ◽  
Seungjin Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Facilities ◽  
Tuberculosis Patients ◽  
Lost To Follow Up

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage.

scholarly journals Can a Difference in Gestational Age According to Biparietal Diameter and Abdominal Circumference Predict Intrapartum Placental Abruption?

2021 ◽  
Vol 10 (11) ◽  
pp. 2413
Author(s):  
Jee-Youn Hong ◽  
Jin-Ha Kim ◽  
Seo-yeon Kim ◽  
Ji-Hee Sung ◽  
Suk-Joo Choi ◽  
...  
Keyword(s):  
Gestational Age ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Maternal Age ◽  
Placental Abruption ◽  
Independent Predictor ◽  
Abdominal Circumference ◽  
Biparietal Diameter ◽  
Study Population ◽  
Independent Risk Factors

This study aimed to investigate whether a difference in gestational age according to biparietal diameter (BPD) and abdominal circumference (AC) could be a clinically useful predictor of placental abruption during the intrapartum period. This retrospective cohort study was based on singletons who were delivered after 32 + 0 weeks between July 2015 and July 2020. We only included cases with at least two antepartum sonographies available within 4 weeks of delivery (n = 2790). We divided the study population into two groups according to the presence or absence of placental abruption and compared the clinical variables. The incidence of placental abruption was 2.0% (56/2790) and was associated with an older maternal age, a higher rate of preeclampsia, and being small for the gestational age. A difference of >2 weeks in gestational age according to BPD and AC occurred at a higher rate in the placental abruption group compared to the no abruption group (>2 weeks, 21.4% (12/56) vs. 7.5% (205/2734), p < 0.001; >3 weeks, 12.5% (7/56) vs. 2.0% (56/2734), p < 0.001). Logistic regression analysis revealed that the differences of >2 weeks and >3 weeks were both independent risk factors for placental abruption (odds ratio (OR) (95% confidence interval), 2.289 (1.140–4.600) and 3.918 (1.517–9.771), respectively) after adjusting for maternal age, preeclampsia, and small for gestational age births. We identified that a difference in gestational age of >2 weeks between BPD and AC could be an independent predictor of placental abruption.

scholarly journals Trends in prevalence of gestational diabetes mellitus in Zhejiang Province, China, 2016–2018

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Meng Wang ◽  
Ru-Ying Hu ◽  
Wei-Wei Gong ◽  
Jin Pan ◽  
Fang-Rong Fei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Rural Areas ◽  
Urban Areas ◽  
Age Groups ◽  
Zhejiang Province ◽  
Advanced Age ◽  
Female Population ◽  
Annual Prevalence

Abstract Background Limited population-based studies have investigated the secular trend of prevalence of gestational diabetes mellitus (GDM) in mainland China. Therefore, this study aimed to estimate the prevalence of GDM and time trends in Chinese female population. Methods Based on Diabetes Surveillance System of Zhejiang Province, 97,063 diagnosed GDM cases aged 20–50 years were identified from January 1, 2016 to December 31, 2018. Annual prevalence, prevalence rate ratios (PRRs) and average annual percentage change with their 95% confidence intervals (CIs) were reported. Results The age-standardized overall prevalence of GDM was reported to be 7.30% (95% CI 7.27–7.33%); 9.13% (95% CI 9.07–9.19%) in urban areas and 6.24% (95% CI 6.21–6.27%) in rural areas. Compared with 20–24 years age group, women in advanced age groups (25–50 years) were at higher risk for GDM (PRRs ranged from 1.37 to 8.95 and the 95% CIs did not include the null). Compared with rural areas, the risk for GDM was higher in urban areas (PRR: 1.69, 95% CI 1.67–1.72). The standardized annual prevalence increased from 6.02% in 2016 to 7.94% in 2018, with an average annual increase of 5.48%, and grew more rapidly in rural than urban areas (11.28% vs. 0.00%). Conclusions This study suggested a significant increase in the prevalence of GDM among Chinese female population in Zhejiang province during 2016–2018, especially in women characterized by advanced age and rural areas.

scholarly journals The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two western Chinese regions

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Li Luo ◽  
Huan Zeng ◽  
Mao Zeng ◽  
Xueqing Liu ◽  
Xianglong Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Western China ◽  
Fetal Macrosomia ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Second Child ◽  
Child Policy ◽  
Significant Difference ◽  
The Impact

Abstract Background After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. Methods A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. Results No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). Conclusions The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.

Fertility intentions among the working population of Dalian City born between 1980 and 1989

2021 ◽  
pp. 1-12
Author(s):  
Hongyan Qiu ◽  
Qun Zhang ◽  
Jin Zhang ◽  
Qingshan Wang ◽  
Lihong Liu ◽  
...  
Keyword(s):  
Family Income ◽  
Reproductive Behaviour ◽  
Fertility Intentions ◽  
Second Child ◽  
Number Of Children ◽  
Child Policy ◽  
Future Fertility ◽  
The Future ◽  
Dalian City ◽  
Ideal Number

Abstract In October 2015, the Chinese Government announced that the one-child policy had finally been replaced by a universal two-child policy. China’s universal two-child policy is highly significant because, for the first time in 36 years, no one in an urban city is restricted to having just one child. This cross-sectional study was conducted to explore future fertility intentions and factors influencing individual reproductive behaviour (whether to have two children) in Dalian City. A total of 1370 respondents were interviewed. The respondents’ mean ideal number of children was only 1.73, and urban respondents’ sex preference was symmetrical. A total of 19.0% of the respondents were unmarried, 64.5% were married and had childbearing experience and only 6.3% of married respondents had two children. Among the 1370 participants, 30.4% stated that they would have a second child, while 69.6% refused to have a second child in the future. Binary logistic regression analysis (Model 1) showed that the following characteristics were associated with having only one child in the future: being female, being older, having a lower education level, being born in Dalian, having a lower family income and reporting one child as the ideal number of children. Model 2 (comprising only respondents with childbearing experience) showed that respondents who were female, had a lower family income and were unable to obtain additional financial support from parents were more likely to intend to stick at one child. In addition, respondents’ ideal number of children and childbearing experiences had a significant influence on future fertility intentions. These results suggest that fertility intentions and reproductive behaviours are still below those needed for replacement level fertility in Dalian City. China’s policymakers should pay more attention to these factors (socioeconomic characteristics, economic factors, desired number of children and childbearing experiences) and try to increase individual reproductive behaviour.

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