高龄妇女体外受精-胚胎移植治疗周期的临床特征和治疗结局分析  

Analysis of the clinical characteristics and outcome of IVF cycles in advanced age women

作　　者：王乐乐[1] 陈士岭[1] 陈薪[1] 施晓鋆[1] 郑海燕[1] 夏容[1] 罗燕群[1] 吴雅琴[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广州510515

出　　处：《中国优生与遗传杂志》2011年第5期105-107,共3页Chinese Journal of Birth Health & Heredity

基　　金：国家重点基础研究发展规划课题(973课题)2007CB948104

摘　　要：目的探讨不同年龄阶段不孕妇女进行体外受精胚胎移植(IVF-ET)治疗的临床特征和治疗结局,为高龄妇女进行辅助生殖治疗提供依据。方法将2003年1月-2010年1月南方医科大学南方医院生殖医学中心共进行的5592个非赠卵IVF/ICSI治疗周期按照年龄分为五组:<35岁(<35岁组,n=3915)、35～37岁(35-组,n=994,)、38～40岁(38-岁组,n=437)、41～42岁(41-岁组,n=153),≥43岁(≥43岁组,n=93),比较和分析各年龄组患者的临床特征和治疗结局。结果 5592个治疗周期中,≥35岁的周期为30.0%,≥38岁的周期占9.8%。五个年龄组的取消周期率分别为6.1%、7.0%、12.1%、17.6%和20.4%,5182个移植周期的临床妊娠率分别为46.7%、41.1%、23.4%、19.0%和8.1%,着床率分别为29.2%、22.3%、11.4%、9.2%%和4.5%,早期流产率分别为7.3%、11.6%、23.6%、20.8%和33.3%,继续妊娠率分别为39.9%、31.8%、16.7%、13.5%和4.1%。随年龄的增加,患者的基础窦状卵泡数(AFC)减少,而基础FSH、Gn剂量增加,获卵数降低。五组患者上述指标相比均有统计学差异(P<0.000)。≥38岁患者的可移植胚胎数减少,≥35岁组患者的早期流产率较<35岁组增加近2倍,而≥38岁患者的早期流产率较≤37岁患者增加2倍以上。结论建议将妇女年龄作为IVF治疗的适应症,对≥35岁妇女不应限制辅助生殖的治疗,对≥38岁女性即使无其它不孕病因亦应提供IVF治疗,由于43岁以上妇女获临床妊娠和继续妊娠的几率很低,是否提供IVF/ICSI治疗需给予充分的知情告知。Objective： To analyze the clinical characteristics and outcome of IVF initiated in women in different age groups,expecting to provide suitable suggestion for treatment.Methods： 5592 fresh non-donor cycles performed from January 2003 to January 2010 in the Reproductive medical center of Nanfang hospital were divided into five groups by female age：〈 35（〈35 years old group,n=3915）,35~37（35-years old group,n=994）,38-40（38-years old group,n=437）,41~42（41-years old group,n=153）,and≥43 years（≥43 years old group,n=93）.The clinical characteristics and outcome were compared and analyzed.Results： Of the 5592 cycles,30% were done in women equal or older than 35 years old,and 9.8% were done in patients older than 38 years.The cancellation rate was 6.1%,7.0%,12.1%,17.6%,and 20.4% in five groups respectively.Of the 5182 transfer cycles,the clinical pregnancy rate in five groups was 46.7%,41.1%,23.4%,19.0%,and 8.1% respectively,the implantation rate was 29.2%,22.3%,11.4%,9.2%%,and 4.5% respectively,the early miscarriage rate was 7.3%,11.6%,23.3%,20.8%,and 33.3% respectively,and the ongoing pregnancy rate of these five groups was 39.9%,31.8%,16.7%,13.5%,and 4.1%.The basal FSH and Gn increased with the female age,while AFC,the number of oocytes retrieved reduced.All of above indicators have significant difference（P〈0.000）among five groups.The transferable embryos of women whose age was 38 or older declined.The early miscarriage rate of 35 years old group of patients were approximately 2 times greater than 〈35 years old patients group.Furthermore,≥38 years old patients＇ early miscarriage rate were 2 times or above greater than those patients whose age was≤37,Conclusions： Female age should be considered as one of the indications of IVF/ICSI.The women≥35 should not be confined to undergo IVF/ICSI,and the women aged 38 or older should be treatment actively even if there were no reasons for their infertility.While,women in 43 years or older should be properly counseled and informed

关 键 词：高龄 体外受精 胚胎移植 临床特征 治疗结局 

分 类 号：R714.8[医药卫生—妇产科学]