Factores pronósticos en FIV

Abstract

In the present work, different parameters or variables of patients with primary infertility submitted to in vitro fertilization (IVF) with fresh embryo transfer were evaluated to determine their influence, statistical significance, in the result of assisted reproduction techniques ( TRA), more concretely with the achievement of clinical and evolutionary gestation, as the previous step to obtain a child at home, ideally unique and healthy. The different variables analyzed have been divided into three groups. The first one includes the baseline characteristics of the patients undergoing IVF, previously determined to controlled ovarian stimulation (EOC): age, body mass index (BMI), FSH (follicle stimulating hormone) basal and basal estradiol. At this point, our data confirm that both age and BMI have a statistically significant influence with gestation rate, inversely, at older age and higher BMI is the probability of gestation. Second, developed the characteristics of the own cycle os ovarian and technical stimulation laboratory technique os oocyte insemination used in the laboratory IVF, type of gonadotropin used for ovarian stimulation, type of ovarian stimulation protocol used and concerted clinic where it is carried out the completion of ovarian stimulation, oocyte maturation and recovery, fertilization, embryonic development control and fresh embryo transfer. As the first three characteristics of this group of variables do not have a significant influence on the gestation rate, in the agreed clinical variable our data demonstrate the great importance that the IVF laboratory has in all assisted reproduction processes, around which the success or failure of the procedure of in vitro fertilization. In the third group of variables, defined after oocyte retrieval, we analyzed several parameters IVF cycle postpuncture: number of recovered total oocytes, number of mature oocytes metaphase II (MII), number of fertilized oocytes (zygotes), number of cryopreserved embryos surplus, number of embryos transferred and day of embryo transfer. At this point, our data indicate the great importance of obtaining an optimal number of mature oocytes of quality for the success of IVF, which we can establish from 10 oocytes and without exceeding the 19 oocytes, all aimed at achieving gestation without owing to the inherent complications of high estrogen levels, such as the ovarian hyperstimulation (HSO), as well as the involvement in embryonic and / or endometrial quality that would reduce the possibility of gestation after embryo transfer in fresh. The different variables, both quantitative and qualitative, have been subjected to a descriptive statistical study determining their statistical significance or not in relation to the gestation rate. The relationship between quantitative variables has been analyzed with Pearson's linear correlation coefficients. The association between qualitative variables has been made through the analysis of contingency tables with the Pearson X2 test complemented with residue analysis to determine the trend of associations. From the statistical data, we have established the comparative with the published studies defining last the conclusions regarding the hypothesis raised. In summary, the objetive of this work, carried out with the aim of obtaining the title of Doctor of Medicine in the speciality of Obstetrics and Gynecology, has been to assess the baseline characteristics of the patients, the cycle of ovarian stimulation and the development of the IVF cycle postpunction can predict the purpose of any ART that is to achieve a child at home, whose first step si to obtain a positive B-hCG.