夫妇首诊生育力评估时年龄组合对IVF-ET/ICSI临床妊娠结局的影响——一项多中心回顾性队列研究  

Effect of age combination on clinical pregnancy outcome in IVF-ET/ICSI at first fertility assessment:a multicenter retrospective cohort study

作　　者：包双明 王冬颖[1] 白符[1] 樊延军[1] BAO Shuang-ming;WANG Dong-ying;BAI Fu;FAN Yan-jun(Department of Assisted Reproductive Technology Management,Maternal and Child Health Center,China Center for Disease Control and Prevention,Beijing 100081,China)

机构地区：[1]中国疾病预防控制中心妇幼保健中心辅助生殖技术管理部,北京100081

出　　处：《现代预防医学》2024年第3期390-394,451,共6页Modern Preventive Medicine

基　　金：国家重点研发计划(2018YFC1002101)。

摘　　要：目的探讨夫妇首诊生育力评估时登记的年龄组合和生育力评估结果对体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)/卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)临床妊娠结局的影响。方法选取东、中、西11家辅助生殖机构IVF-ET/ICSI共5104个移植周期的资料建立回顾性队列,依据夫妇首诊生育力评估时登记的年龄分组分析:A组(女方<35岁,男方<40岁)、B组(女方<35岁,男方≥40岁)、C组(女方≥35岁,男方<40岁)、D组(女方≥35岁,男方≥40岁)。采用χ^(2)检验和单因素方差分析比较四组间临床妊娠率和首诊生育力评估结果。结果四个年龄组合IVF-ET治疗的临床妊娠率分别为58.23%、54.12%、40.57%、30.70%(χ^(2)=167.214,P<0.001);ICSI治疗的临床妊娠率分别为59.29%、62.50%、49.07%、34.31%(χ^(2)=23.834,P<0.001);A与B组间IVF-ET/ICSI两种治疗临床妊娠率的差异均无统计学意义(χ^(2)=0.574,PIVF-ET=0.449;χ^(2)=0.099,PICSI=0.754);C组IVF-ET/ICSI两种治疗的临床妊娠率均显著高于D组(χ^(2)=11.581,PIVF-ET=0.001;χ^(2)=4.695,PICSI=0.03)。结论女方<35岁时,男方年龄对IVF-ET/ICSI治疗的临床妊娠率没有显著影响;女方≥35岁时,男方<40岁接受IVF-ET/ICSI治疗的临床妊娠率显著优于男方≥40岁的人群,这提示有生育意愿的夫妇若已处于女方≥35岁,男方<40岁的组合年龄区间时,应积极进行生育力评估并及时选择恰当的医学治疗方案。Objective To investigate the effects of age combinations and fertility assessment results on the clinical pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI).Methods A retrospective cohort was established based on the data of 5104 cycles of IVF-ET/ICSI transplantation from 11 assisted reproductive institutions in the east,central,and west regions.According to the age registered at the first fertility evaluation,the couples were divided into group A(female<35,male<40),group B(female<35,male≥40),group C(female≥35,male<40),and group D(female≥35,male≥40).The results of clinical pregnancy rate and first fertility among the four groups were compared by Chi-square test and one-way ANOVA.Results The clinical pregnancy rates of the four age groups treated with IVF-ET were 58.23%,54.12%,40.57%,and 30.70%,respectively(χ^(2)=167.214,P<0.001),and those of ICSI were 59.29%,62.5%,49.07%,and 34.31%,respectively(χ^(2)=23.834,P<0.001).There was no significant difference in the clinical pregnancy rate between the two treatments of IVF-ET/ICSI between group A and group B(χ^(2)=0.574,PIVF-ET=0.449,χ^(2)=0.099,PICSI=0.754)but the clinical pregnancy rate of group C was significantly higher than that of group D in the two treatments of IVFET/ICSI,which was(χ^(2)=11.581,PIVF-ET=0.001;χ^(2)=4.695,PICSI=0.03).Conclusion When the woman is less than 35 years old,the age of the man has no significant effect on the clinical pregnancy rate treated with IVF-ET/ICSI.When the woman is≥35 years old,the clinical pregnancy rate of the man<40 years old receiving IVF-ET/ICSI is significantly higher than that of the man≥40 years old,which suggests that if the couple with fertility intention is in the age range of≥35 years old for woman and<40 years old for man,they should actively evaluate the fertility and choose the appropriate medical treatment plan in time.

关 键 词：首次生育力评估 年龄组合 妊娠结局 体外受精-胚胎移植 卵胞浆内单精子显微注射 

分 类 号：R714.8[医药卫生—妇产科学]