{"id":72,"title":"Chance of live birth in women with recurrent pregnancy loss referred to a French assisted reproductive technology center","title_zh":"反复妊娠丢失女性转诊至法国辅助生殖中心后的活产率及成功预测因素：一项回顾性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42983561","doi":"10.1186/s12978-026-02433-7","pmid":"42983561","journal":"Reprod Health","kind":"paper","lang":"en","published_at":"2026-08-08T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Derradj S","Vandecandelaere A","Loiseau P","Bosquet D","Cabry R","Dernoncourt A"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":12.0,"hits":["assisted reproductive","icsi","infertile","infertility","ivf","live birth"]},{"slug":"early-pregnancy","score":6.0,"hits":["miscarriages","recurrent pregnancy loss","rpl"]},{"slug":"oocyte","score":1.0,"hits":["ovarian reserve"]},{"slug":"repro-endo","score":1.0,"hits":["diminished ovarian reserve"]},{"slug":"ethics-policy","score":1.0,"hits":["consensus"]}],"topic_score":12.0,"preference_score":0.0,"preference_labels":[],"llm_score":70.0,"final_score":70.0,"score_dims":{"novelty":55,"rigor":62,"impact":62,"relevance":95,"translation":74},"recommend_reason":"为“反复妊娠丢失是否应转诊ART”这一缺乏共识的临床问题提供了真实世界数据，提示多数患者可自然受孕获得活产、ART应限于合并不孕者；但单中心、样本量85例、回顾性设计限制了结论外推。","keywords":["反复妊娠丢失","活产率","辅助生殖技术","自然妊娠","卵巢储备","预测因素"],"selected":1,"story_id":453,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":3,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究为法国Amiens-Picardie大学医院ART中心的回顾性队列研究，纳入2014–2022年85例18–42岁、孕14周前≥3次妊娠丢失并转诊的女性（中位年龄29.6岁，58.8%未产，中位流产3次）。结果显示，75.3%（64/85）获得至少一次活产，其中52%为自然妊娠、48%经ART，两者中位受孕时间分别为13.6与14.2个月。合并不孕者ART使用率更高（72.2% vs 34.7%，p=0.001）。卵巢储备功能减退与既往流产次数增多为活产率降低的独立预测因素（aOR 0.26与0.76）。作者认为ART应保留给确诊不孕或存在明确病因的夫妇。","summary":"BACKGROUND: Recurrent pregnancy loss (RPL) is a multifactorial condition, with over 50% of cases remaining unexplained. The absence of therapeutic consensus raises questions regarding referral for assisted reproductive technology (ART). OBJECTIVE: To evaluate live birth rates and predictors of success among women with RPL referred to a tertiary ART center. METHODS: We conducted a retrospective cohort study. Women aged 18-42 years with ≥ 3 pregnancy losses before 14 weeks' gestation, referred to the ART center of Amiens-Picardie University Hospital (2014-2022) were included. The primary outcome was achieving a live birth during follow-up. Independent predictors were identified using stepwise logistic regression. RESULTS: Among the 85 women with RPL included (median age 29.6 [8.6] years), 49/85 (57.6%) had no underlying infertility issues, and 36/85 (42.3%) had associated infertility issues. Most women were nulliparous (50/85, 58.8%), and had a median of 3 [1] previous miscarriages. Overall, 64/85 (75.3%) achieved at least one live birth: 33/64 (52%) spontaneously and 31/64 (48%) via ART, with median times to conception of 13.6 [10.5] and 14.2 [10.6] months, respectively. ART use was more frequent among infertile women (≥1 IVF/ICSI cycle: 26/36, 72.2% vs. 17/49, 34.7%; p = 0.001), leading to a higher proportion of medically-assisted conceptions in this group (20/24, 83.3% vs. 11/40, 27.5%; p < 0.001). Diminished ovarian reserve and a higher number of previous miscarriages were independently associated with lower live birth rates (aOR 0.26 [0.08-0.89] and 0.76 [0.53-0.96], respectively). CONCLUSION: Approximately three-quarters of women with RPL achieved a live birth, most after spontaneous conception. ART should be reserved for couples with confirmed infertility or when another underlying cause clearly justifies intervention.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}