国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2011, Vol. 30 ›› Issue (4): 265-271.

• 专家论坛 • 上一篇    下一篇

女性年龄与不孕及生育力减退

陈士岭 罗燕群 夏 容 王乐乐 吴雅琴   

  1. 510515 广州，南方医科大学南方医院妇产科生殖医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-07-15 发布日期:2011-07-15
  • 通讯作者: 陈士岭

Aging，Infertility and Age-related Fertility Decline in Women

CHEN Shi-ling， LUO Yan-qun， XIA Rong， WANG Le-le， WU Ya-qin   

  1. Center for Reproductive Medicine， Nanfang Hospital， Southern Medical University， Guangzhou 510515， China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-07-15 Online:2011-07-15
  • Contact: CHEN Shi-ling

PDF (PC)

7351

摘要： 女性年龄增加导致不孕和生育力下降的主要原因是卵巢储备功能降低，对高龄不孕妇女的检查应首先评价卵巢储备功能，同时进行不孕相关检查了解其生育能力信息。临床常用卵巢储备功能的检查有卵泡早期卵泡刺激素、雌二醇和氯米芬刺激试验。关于窦状卵泡计数、抑制素B和抗苗勒管激素用于卵巢储备功能评估的研究已有许多。妊娠前咨询时应告知随年龄增加而增加的风险，包括胚胎非整倍体、自然流产、剖宫产术相关并发症、妊娠期高血压疾病及相关并发症、妊娠期糖尿病、早产、低出生体质量儿和死胎等。高龄妇女不孕症的辅助生殖方法包括控制性超排卵（COH）/人工授精（IUI）、体外受精-胚胎移植（IVF-ET）及赠卵。当今因年龄问题导致不孕发生率和自然流产增加，活产率降低。年龄是无法改变的影响女性生育能力的重要因素，应教育女性在适当年龄生育，对35岁以上妇女应积极进行不孕症诊断和治疗。

关键词: 年龄因素, 不育, 女(雌)性, 生育力, 卵巢, 流产, 自然, 生殖技术, 辅助

Abstract: Main pathophysiological mechanism of the descending ability of conceive and infertility in aging women is insufficient ovarian reserve. So ovarian reserve should firstly be evaluated in those age?鄄advancing women with infertility, and other related examination was also combined to evaluate the ability to conceive. Ovarian reserve was usually evaluated in clinic by FSH and E2 levels at early stage of follicle, as well as clomiphene stimulating test. The antral follicle count（ＡＦＣ） and inhibin B level were also reported to test ovarian reserve. Advancing age in women is associated with accelerating decline to conceive and increase the risks of miscarriage or of stillbirth or of genetic abnormality in surviving offspring. Treatment options for age?鄄related infertility include controlled the ovarian hyperstimulation with intrauterine insemination（COH/IUI）, IVF, and oocyte donation. Since age is a significant factor influencing woman’s ability of conceive, women should be encouraged to have child in their suitable age. Women aged over 35 years with infertility should be promptly diagnosed and positively treated.

Key words: Age factors, Infertility, female, Fertility, Ovary, Abortion, spontaneous, Reproductive techniques, assisted