国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (3): 239-242.

• 论著 • 上一篇    下一篇

年龄对长方案体外受精-胚胎移植助孕的影响

张静，孙博，卜志勤，孙莹璞   

  1. 450052 郑州大学第一附属医院生殖医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-05-15 发布日期:2014-05-15
  • 通讯作者: 孙莹璞

Effect of Female Age on Outcomes of IVF-ET during Long Protocols Controlled Ovarian Hyperstimulation

ZHANG Jing, SUN Bo, BU Zhi-qin, SUN Ying-pu   

  1. Reproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-05-15 Online:2014-05-15
  • Contact: SUN Ying-pu

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摘要： 目的：探讨年龄对长方案体外受精-胚胎移植（IVF-ET）助孕卵巢反应和结局的影响规律，并确定最佳助孕年龄。方法：回顾性分析2011年5月—2012年5月于郑州大学第一附属医院生殖医学中心行长方案IVF-ET的控制性超促排卵治疗周期共2 468个。按照患者年龄分为4组：A组（＜25岁，170个周期）、B组（25～29岁，741个周期）、C组（30～34岁，866个周期）及D组（≥35岁，691个周期）。比较不同年龄组患者实验室各项指标及妊娠结局的差异。结果：4组不孕时间随年龄增加而逐渐增加，A、B、C组基础卵泡刺激素（bFSH）水平差异无统计学意义，D组高于此3组。窦卵泡数、基础黄体生成激素（bLH）水平随年龄增加而减少。4组促性腺激素（Gn）用量随年龄增加而增加，获卵数随年龄增加而减少。A组正常受精率最低，与其余3组比较差异有统计学意义。B组优胚率最高，与年龄偏大组（C组、D组）及年龄偏小组（A组）相比较，差异有统计学意义。生化妊娠率及活产率随年龄增加而降低，流产率随年龄增加而增加。B组临床妊娠率最高，与D组比较差异有统计学意义。D组活产率明显减低且流产率明显增加。结论：长方案IVF-EF助孕，＜25岁的患者与25～29岁的患者比较，卵子质量及胚胎质量较差，而妊娠结局并未受到影响。随着年龄增大，尤其是35岁以后卵巢储备功能明显下降，IVF妊娠结局较差。

关键词: 受精, 体外, 胚胎移植, 超排卵, 年龄因素, 妊娠结局

Abstract: Objective：To investigate the effect of female age on the pregnancy outcomes, as well as ovarian responses, of in vitro fertilization-embryo transfer（IVF -ET）, and to find the optimal age range for women undergoing the associated reproduction treatments. Methods: This is a retrospective analysis of all patients firstly undergoing IVF -ET using the standard long protocol for the controlled ovarian hyperstimulation（COH） in our center from May 2011 to May 2012. Patients were divided into four groups according to female age: age of the group A was 20-24 years old（n=170）, the group B 25-29 years old（n=741）, the group C 30-34 years old（n=866）, and the group D over 35 years old（n=691）. The laboratory indexes and main clinical outcomes [pregnancy rate, miscarriage rate and live birth rate（LBR）] were compared. Results：The duration of infertility was significantly longer following female age. The basal FSH level of the group D was significantly higher than those of other groups, while AFC and the basal LH level were significantly lower following age. The mean total dose of Gn was increased following age, while the number of mean retrieved oocyte was decreased. The 2PN zygote rate in group A was significantly lowest. The high quality embryo rate was significantly higher in the group B than this in other groups. The biochemical pregnancy rate and LBR were significantly lowered following age, while the spontaneous abortion rate was increased following age. The clinical pregnancy rate of group B is significantly higher than group D. LBR in the group D was significantly lower, and the spontaneous abortion rate was higher when compared with other groups. Conclusions: The oocyte quality and embryo quality in those women aged <25 years undergoing ART are not better than those in women aged 25-29 years, while the pregnancy rates in two groups are similar. The ovarian reserve, and pregnancy outcome of IVF-ET, will reduce following age, especially in those women aged over 35 years.

Key words: Fertilization in vitro, Embryo transfer, Superovulation, Age factors, Pregnancy outcome