南方医科大学学报2016，Vol.36Issue(12)：1632-1637,6.DOI:10.3969/j.issn.1673-4254.2016.12.08
40岁以上妇女行体外受精-胚胎移植治疗的结局分析
Clinical outcome of in vitro fertilization or intracytoplasmic sperm injection-embryo transfer in women aged 40 years and above
摘要
Abstract
Objective To investigate the clinical outcomes in vitro fertilization or intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in women aged over 40 years.Methods We retrospectively analyzed 1050 non-donor IVF/ICSI-ET cycles performed from January,2007 to December,2015 in women at the age 40 years or above,including 393 women at 40 years of age,266 at 41 years,158 at 42 years,107 at 43 years,64 at 44 years,and 65 at 45-51 years.The clinical characteristics and outcomes of the women in different age groups were compared and analyzed.The pregnancy outcome of different ovarian stimulation protocols and different numbers of embryo transferred were also compared.Results Oocyte retrieval was achieved in 1032 treatment cycles.Of the 750 embryo transfer cycles,the clinical pregnancy rate was 17.7％ (113/750),and the live birth rate was 8.5％ (64/750).The clinical pregnancy rate in the 5 age groups was 23.4％,21.0％,13.1％,9.2％,5.6％ and 0％,and the implantation rate was 11.2％,10.2％,6.3％,5.1％,2.3％ and 0％,respectively;the early spontaneous abortion rate was 31.0％,35.9％,42.9％,42.9％ and 100％,and the live birth rate was 11.9％,11.8％,2.8％ and 3.9％.The clinical pregnancy rates of long protocol,short protocol,GnRHa antagonist protocol,and ovulation induction protocol were 23.6％,10.2％,13.3％,and 2.3％,respectively.In the 750 transfer cycles,the clinical pregnancy rate was 3.8％ with single embryo transfer,12.6％ with double embryos transfer,and 23.0％ with 3 embryos transfer.Conclusion In women aged 40 years or above,the clinical pregnancy rate decreased signiacantly with age,and the live birth rate was extremely low in women aged beyond 44 years.Assisted reproductive technique is recommended for women aged 40 years and above even when no identifiable causes of sterility are present.For women aged above 44 years of age,oocyte donation may be a better option.关键词
体外受精-胚胎移植/辅助生殖技术/高龄妇女Key words
in vitro fertilization/intracytoplasmic sperm injection-embryo transfer/assisted reproductive techniques/elderly women of child bearing age引用本文复制引用
周星宇,冯淑娴,李雪兰,刘玉东,陈薪,叶德盛,牛静,陈士岭..40岁以上妇女行体外受精-胚胎移植治疗的结局分析[J].南方医科大学学报,2016,36(12):1632-1637,6.基金项目
国家自然科学基金(81170574),广东省省级科技计划(2016A020218009)Supported by National Natural Science Foundation of China (81170574). （81170574）
