Pre- and Procedural Factors Influencing the Success of In Vitro Fertilization: Evaluating Embryo Quality and Clinical Pregnancy in Cases of Tubal Factor Infertility

<b>Introduction</b>: While tubal occlusion is a prevalent cause of infertility, accounting for 11-35% of infertility cases among women, there remains a limited understanding of the factors influencing clinical pregnancy following in vitro fertilization (IVF). <b>Methods</b>: In our retrospective, cross-sectional cohort study conducted at a single tertiary center, medical records of women aged 19 to 43 years were analyzed. Logistic regression models were employed to identify the prognostic factors associated with clinical pregnancy after IVF in patients with tubal factor infertility, excluding cases with hydrosalpinx. <b>Results</b>: Data from 219 women diagnosed with tubal occlusion were compared to 1140 cases with non-tubal indication, covering a total of 1359 IVF cycles. A lower maternal age (adjusted odds ratio [AOR]: 0.89, <i>p</i> = 0.001) and a higher embryo quality (AOR: 1.26, <i>p</i> = 0.01) emerged as important factors in clinical pregnancy in the tubal infertility group. Moreover, a lower maternal (AOR:0.91, <i>p</i> < 0.01) and paternal age (<i>p</i> = 0.001), and favorable semen quality (AOR: 1.32, <i>p</i> = 0.03) were critical determinants in the non-tubal infertility group. BMI was generally higher in tubal infertility patients (<i>p</i> = 0.01). Furthermore, FSH level (AOR: 0.93, <i>p</i> = 0.004), AMH level (<i>p</i> < 0.04), number of embryos transferred (AOR: 2.04, <i>p</i> < 0.001), and embryo quality (AOR: 1.26, <i>p</i> < 0.001) came into prominence only in the non-tubal infertility group. The clinical pregnancy rate (34.2%) of women with tubal occlusion did not differ significantly from those in other forms of infertility undergoing IVF (35.4%). <b>Conclusions</b>: Although tubal infertility is typically anticipated to yield the highest clinical pregnancy rates following IVF, it is crucial to acknowledge that both maternal and paternal characteristics can also significantly impact the outcomes.