Impact of maternal education level on live birth rate after in vitro fertilization: a retrospective cohort study

Objective: To examine the association between maternal education level and live birth after in vitro fertilization (IVF). Design Retrospective cohort study. Setting Public fertility center in China. Population 41546 women who underwent the first cycle of fresh or frozen-thawed embryo transfer between 2014 and 2019. Methods The women were divided into four educational categories according to the level of education received (elementary school graduate or less, middle school graduate, high school graduate, college graduate or higher). Main outcome measures Live birth rates. Results Patients were grouped by maternal educational level: elementary school graduate or less (n=1590), middle school graduate (n=10996), high school graduate (n=8354), and college graduate or higher (n=20606). The live birth rate, miscarriage rate, and clinical pregnancy rate in elementary school graduate or less were lower compared to other groups. In multivariate logistic regression analysis, we fail to demonstrate a statistically significant relationship between educational level and live birth in middle school graduate (adjusted odds ratio [AOR] 0.96; 95% confidence interval [CI], 0.84-1.09), high school graduate (AOR 1.01; 95% CI, 0.87-1.14) or college graduate or higher (AOR 1.01; 95% CI, 0.88-1.14) patients compared with the elementary school graduate or less reference group after adjusting for female age, infertility duration, BMI, EM thickness, no. of oocyte retrieved, infertility type, protocol in the fresh cycle, fertilization type, time of transfer and no. of embryo transferred. Conclusion No statistically significant relationship was identified between educational level and live birth in patients undergoing fresh or frozen embryo transfer.