Age at menarche and clinical outcomes following medically assisted reproduction (MAR): a cohort study

Abstract

Medically assisted reproduction (MAR) technologies have advanced rapidly, but in contrast to the specificity of modern approaches, they provide limited effectiveness in the management of the infertile couple. The purpose of this study was to assess the possible relationship between age at menarche and MAR outcomes of clinical pregnancy, live birth and the adverse incident of miscarriage, and to determine the offspring sex ratio according to age at menarche. In a cohort of 254 infertile couples who underwent 426 IVF/ICSI cycles, statistical analysis was performed by applying Student’s t-test, chi-square test, and logistic regression models, adequately in the respective parameters and outcomes. The results indicated a strong association of age at menarche with the outcomes of clinical pregnancy (p = .0007) and live birth (p < .0001), especially by applying a threshold of 12 years in the first occurrence of menstruation (p = .0019 for clinical pregnancy, p < .0001 for live birth), also demonstrating a negative effect for earlier menarche that acts in parallel with the increasing age of the woman. Calculation of sex ratio demonstrated a tendency towards female offspring close to the age at menarche of 12 years. Age at menarche could serve as a surrogate parameter for reproductive potential towards personalized management of infertility.

摘要

医学辅助生殖(MAR)技术发展迅速, 但与现代方法的特异性相比, 它对不孕夫妇的管理效果有限。本研究旨在探讨初潮年龄与MAR后临床妊娠、活产、流产不良事件之间的相关性, 并根据初潮年龄确定后代性别比例。这项队列研究包括254对不孕夫妇, 他们共接受了426个IVF/ICSI周期, 采用t检验、卡方检验和logistic回归模型对相关参数和结果进行充分的统计学分析。结果显示月经初潮年龄与临床妊娠的结果(p<.0007)和活产(p<.0001)相关性显著,特别是将月经初潮的阈值定在12岁(p<.0019 临床妊娠, p<.0001 活产), 这也表明, 初潮年龄提前对女性年龄的增长也会产生负面影响。性别比的计算显示：初潮年龄12岁的女性后代性别比趋于接近。初潮年龄可作为生育潜力的替代参数, 用于不孕患者的个性化管理。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Menarche
• clinical pregnancy
• live birth
• assisted reproduction
• MAR

Disclosure statement

No potential conflict of interest was reported by the authors.