Impact of Clinical and Treatment Factors on Clinical Pregnancy and Live Birth in IVF/ICSI-ET: A Retrospective Cohort Study

Objective: This study aimed to evaluate the impact of clinical, hormonal, and embryologic factors on clinical pregnancy and live birth outcomes in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods: This retrospective cohort analysis included Clinical, endocrine, and embryological data in 178 IVF/ICSI-ET cycles performed at a single reproductive medicine center from January 2020 to December 2024. Clinical pregnancy and live birth served as the primary outcomes. Statistical analyses included univariate and multivariate logistic regression and ROC curve analysis assessing the discriminative abilityof male age. Results: Among the 139 IVF/ICSI-ET cycles meeting inclusion criteria, the clinical pregnancy rate was 51.8%, with a live birth rate of 38.1%. The pregnancy group exhibited significantly younger male age, lower basal AMH, shorter infertility duration, and more double-embryo transfers (all p < 0.05). Multivariate analysis identified male age as the sole independently associated factor of clinical pregnancy (OR = 0.85). ROC analysis indicated moderate discriminative abilityat a cut-off of 31.5 years (AUC = 0.620). Among pregnant patients, live birth was associated with younger female and male age, lower gonadotropin doses, and double-embryo transfer in univariate analysis (p < 0.05), but no independently associated factors were confirmed on multivariate analysis (p > 0.05). Conclusion: Male age appears to play a significant role in clinical pregnancy outcomes in IVF/ICSI-ET, highlighting the importance of incorporating paternal factors into fertility assessments.