Pregnancy and live birth rates in ART cycles and their determinants: A retrospective cohort study

Abstract

Objective: To identify predictors of pregnancy and live birth outcomes in assisted reproductive technology (ART) cycles based on patient characteristics, hormonal profile, and embryo transfer variables.

Methods: This retrospective cohort study included 50 fresh in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles selected from ART participants at a single tertiary ART center. Controlled ovarian stimulation was performed using recombinant follicle stimulating hormone (rFSH), gonadotropin-releasing hormone (GnRH) antagonist, and menotropins; oocyte retrieval occurred 36 h after trigger and embryo transfer was performed on day 3 or 5. Outcomes (chemical pregnancy, ongoing pregnancy, abortion, live birth) were compared across groups stratified by maternal age, antral follicle count (AFC), anti-Müllerian hormone (AMH), baseline luteinizing hormone (LH), estradiol (E₂) at trigger, and endometrial thickness. Multivariate regression was used to identify independent predictors of live birth.

Results: A total of 124 ART patients were screened during the study period, of whom 50 participants meeting the eligibility criteria were included in the final analysis. The median age of the participants was 35.8 years [interquartile range (IQR) 32.5-39.6]. The median AFC was 8 (IQR 4-14), AMH level was 1.4 ng/mL (IQR 0.7-2.9), and the median endometrial thickness at embryo transfer was 10.2 mm (IQR 9.0-11.3). Chemical, ongoing, abortion, and live birth rates were 62%, 32%, 12%, and 16%, respectively. Younger maternal age (<35 years), higher AFC (>12), AMH 1-4 ng/mL, and endometrial thickness >10 mm were associated with more favorable pregnancy outcomes. In multivariate analysis, higher baseline LH (β=0.089; 95% CI 0.017-0.162; P=0.02) and greater endometrial thickness (β=0.145; 95% CI 0.011-0.278; P=0.04) independently predicted live birth, whereas age, AFC, AMH, and E₂ did not.

Conclusions: Maternal age, ovarian reserve markers, LH levels, and endometrial thickness collectively influence ART outcomes. Baseline LH and endometrial receptivity are key independent predictors of live birth and may guide individualized treatment strategies.

Keywords

Assisted reproductive technology / Live birth / Ovarian reserve / Endometrial thickness / Luteinizing hormone

Conflict of interest statement

The authors have no competing interests to declare.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors’ contributions

Chandan V Salunke conceptualized the study, supervised data acquisition, and critically revised the manuscript. Shravani K.S Parker contributed to data collection, performed the statistical analysis, and drafted the initial manuscript. Ameet A Naik assisted in clinical data acquisition, interpretation of findings, and manuscript editing. Abhijit J Kamat supported laboratory data review, literature curation, and final manuscript refinement. All authors reviewed and approved the final version of the manuscript and agree to be accountable for all aspects of the work.

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