45岁以上卵巢功能衰退女性受卵助孕  

Assisted reproduction in women over 45 years old with ovaries failure

作　　者：纪亚忠[1,2] 宋桂红[2] 田立霞[2] 惠宁[2] 古航[2] 孙磊[2] 佘立平[2] 松迪[2] 

机构地区：[1]上海同济医院生殖医学中心,200065 [2]上海长海医院生殖医学中心

出　　处：《中国妇幼保健》2010年第32期4754-4756,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨符合计划生育政策、45周岁以上女性受卵助孕的可行性。方法：4550周岁女性10例,其中4例已绝经,6例月经不规则。所有卵子均经卵细胞浆内单精子注射（ICSI）受精,冷冻所有胚胎,择期在激素替代（HRT）周期下行冷冻胚胎移植（FET）。结果：10个周期获得赠卵47个（平均4.7个）,冷冻胚胎36个,解冻后获得可移植胚胎25个。在HRT的1620天行FET。获生化妊娠7例（70%）,移植4周后阴超见临床妊娠6例（60%）。5例为单胎,1例为双胎,其中1例孕2个月流产,其余5例均经剖宫产分娩健康新生儿,移植周期临床妊娠率60%,移植周期分娩率50%。最高分娩年龄51岁,为双胎。结论：体外受精-胚胎移植（IVF-ET）技术可成为治疗45岁以上卵巢功能衰退女性的助孕捷径;成熟的IVF-ET临床及实验室条件、子宫内膜受容性调整及黄体支持治疗是该项技术的三大关键因素;该技术可引发如卵子来源、高危妊娠并发症、高龄双亲等伦理及法律问题。Objective：To assist women over 45 years old with ovaries failure to get pregnancy with ovum donation-IVF.Methods：10 women with 45～50 years old,including 4 with menopause,and 6 with irregular menses.Fertilization with ICSI,and frozen all embryos,then FET following HRT.Results：Fertilization with 47 donor eggs,36 embryos were frozen.After HRT 16～20d,2～3 frozen embryos were transferred and 7/10（70%） were found with serum hCG elevation,then 6/10（60%） clinical gestations were detected in 4 weeks.One was aborted in 8 weeks,and the others delivered healthy babies by cesarean section.Conclusion：Ovum Donation-IVF is a useful technique to help women over 45 years old with ovaries failure to get pregnancy.The key points in this technique are clinical IVF-ET performance,endometrial receptivity adjustment and luteal supportive treatment.This technique initiates some ethics and legal issues,such as ovum source,pregnancy complications and advanced age parents,etc.

关 键 词：体外受精-胚胎移植 卵细胞浆内单精子注射 冷冻胚胎移植 受卵 

分 类 号：R711.75[医药卫生—妇产科学]