Resultaten van in-vitrofertilisatie bij Nederlandse subfertiele paren uitgeweken naar Gent, 1993-2002: geen patiëntengroep met verminderde prognose

To describe the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) of Dutch patients who came to Ghent University Hospital (GHU), Belgium, for treatment, during the period 1993-2002.

Design

Retrospective data collection, description and analysis.

Method

Dutch and Belgian patients were compared with respect to: age, indication for treatment, duration of infertility, stimulation protocol, number of ampoules of gonadotrophins, duration of stimulation, number of follicles, number of oocytes, number of fertilized oocytes, number of transferred embryos, quality of transferred embryos, number of frozen embryos, pregnancy, outcome of pregnancy, duration of pregnancy, sex and weight of the child or children.

Results

In the period 1993-2002 (10 years), 6099 treatment cycles were carried out in Belgian and 4801 in Dutch couples in the GHU. The duration of infertility was longer for the Dutch than for the Belgian couples and the Dutch women were on average three years older than the Belgian. The male infertility rate and proportion of ICSI cycles was higher for the Dutch than for the Belgian couples. In 17 of the cycles surgically retrieved sperm was used because of azoospermia. The numbers of follicles, oocytes retrieved, as well as the number of fertilized oocytes were all larger for the Belgian than for the Dutch patients. An equal number of embryos was transferred in both groups (2.24). The ongoing pregnancy rate per cycle was a little lower for the Dutch (23.2) than for the Belgian couples (25.3). The percentage multiple pregnancies was not different (27.8 for the Belgian and 25.1 for the Dutch patients). The Dutch singleton babies were born six days later than the Belgian, but the children differed in no other way. From 1996 to 2000 the ongoing pregnancy rate was 23.8 per first cycle for Dutch patients treated in the UHG, as compared to 19.4 in the Netherlands.

Conclusion

Dutch patients treated in the GHU differed from Belgian patients in that they had a longer duration of infertility and a longer history of previously failed treatments. Although the pregnancy results were slightly lower for Dutch than for Belgian patients, this does not seem to be clinically very relevant, especially not in view of the overall Dutch national results.