您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (1): 22-25.doi: 10.6040/j.issn.1671-7554.0.2016.1332

• 高龄生育专题 • 上一篇    下一篇

高龄女性助孕措施选择

石玉华,李敬   

  1. 山东大学附属生殖医院 国家辅助生殖与优生工程技术研究中心 生殖内分泌教育部重点实验室(山东大学)山东省生殖医学重点实验室, 山东 济南 250001
  • 收稿日期:2016-10-18 出版日期:2017-01-10 发布日期:2017-01-10
  • 通讯作者: 石玉华. E-mail:shiyuhua2003@126.com E-mail:shiyuhua2003@126.com
  • 基金资助:
    国家科技支撑计划(2012BAI32B04);国家自然科学基金面上项目(81471428);山东省科技发展计划(2014GSF118070);山东省人口和计划生育委员会科技计划(2013-03);山东大学附属生殖医院自主创新项目(20141102)

Strategies for infertility treatment in elderly women

SHI Yuhua, LI Jing   

  1. Center for Reproductive Medicine, Shandong University;
    National Research Center for Assisted Reproductive Technology and Reproductive Genetics;
    Key Laboratory of Reproductive Endocrinology(Shandong University), Ministry of Education;
    Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan 250001, Shandong, China
  • Received:2016-10-18 Online:2017-01-10 Published:2017-01-10

PDF (PC)

337

摘要： 高龄女性生育力下降,活产率降低,有生育要求时应及时去医院做相关检查,正确评估生育能力及妊娠相关风险,通过助孕技术,如促排卵指导同房(或人工授精)、选用辅助生殖技术和辅助药物(重组人促黄体生成素、生长激素、辅酶Q10、脱氢表雄酮、雌激素等)及改变生活方式可提高活产率,赠卵可能是最有效的助孕措施。

关键词: 高龄, 体外受精, 不孕, 助孕

Abstract: Women older than 35 years of age should be counseled about age-related fertility decline and high risk of pregnancy complications if they have the desire of fertility. After failed attempts to conceive, in vitro fertilization(IVF), assisted reproductive techniques and adjunct agents may be adopted, including recombinant luteinizing hormone(r-LH), growth hormone(GH), coenzyme Q10(CoQ10), and dehydroepiandrosterone(DHEA). Change of life style may increase live birth rate. Oocyte donation may be the most effective assisted reproductive strategy.

Key words: Infertility, In vitro fertilization, Assisted reproductive technology, Elderly women

中图分类号: 

  • R711.6
[1] American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589[J]. Fertil Steril, 2014, 101(3): 633-634.
[2] Toner JP, Coddington CC, Doody K, et al. Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update[J]. Fertil Steril, 2016, 106(3): 541-546.
[3] Liu K, Case A, Cheung AP, et al. Advanced reproductive age and fertility[J]. J Obstet Gynaecol Can, 2011, 33(11): 1165-1175.
[4] Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion[J]. Fertil Steril, 2015, 103(6): e44-50.
[5] 中华医学会妇产科学分会产科学组. 孕前和孕期保健指南(第1版)[J]. 中华妇产科杂志, 2011, 46(2): 150-153.
[6] Wennberg AL, Opdahl S, Bergh C, et al. Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology[J]. Fertil Steril, 2016, 106(5): 1142-1149.e14.
[7] Tsafrir A, Simon A, Margalioth EJ, et al. What should be the first-line treatment for unexplained infertility in women over 40 years of age-ovulation induction and IUI, or IVF?[J]. Reprod Biomed Online, 2009, 19(Suppl 4): 47-56.
[8] Goldman MB, Thornton KL, Ryley D, et al. A randomized clinical trial to determine optimal infertility treatment in older couples: the forty and over treatment trial(FORT-T)[J]. Fertil Steril, 2014, 101(6): 1574-1581 e1-2.
[9] Lazer T, Dar S, Shlush E, et al. Comparison of IVF outcomes between minimal stimulation and high-dose stimulation for patients with poor ovarian reserve[J]. Int J Reprod Med, 2014, 2014: 581451. doi: 10.1155/2014/581451.
[10] Wong PC, Qiao J, Ho C, et al. Current opinion on use of luteinizing hormone supplementation in assisted reproduction therapy: an Asian perspective[J]. Reprod Biomed Online, 2011, 23(1): 81-90.
[11] Duffy JM, Ahmad G, Mohiyiddeen L, et al. Growth hormone for in vitro fertilization[J]. Cochrane Database Syst Rev, 2010,(1): CD000099. doi: 10.1002/14651858.CD000099.pub3.
[12] Yu X, Ruan J, He LP, et al. Efficacy of growth hormone supplementation with gonadotrophins in vitro fertilization for poor ovarian responders: an updated meta-analysis[J]. Int J Clin Exp Med, 2015, 8(4): 4954-4967.
[13] Ben-Meir A, Burstein E, Borrego-Alvarez A, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging[J]. Aging Cell, 2015, 14(5): 887-895.
[14] Ozcan P, Ficicioglu C, Kizilkale O, et al. Can coenzyme Q10 supplementation protect the ovarian reserve against oxidative damage?[J]. J Assist Reprod Genet, 2016, 33(9): 1223-1230.
[15] Bentov Y, Hannam T, Jurisicova A, et al. Coenzyme Q10 supplementation and oocyte aneuploidy in women undergoing IVF-ICSI treatment[J]. Clin Med Insights Reprod Health, 2014, 8: 31-36. doi: 10.4137/CMRH.S14681.
[16] Sen A, Prizant H, Light A, et al. Androgens regulate ovarian follicular development by increasing follicle stimulating hormone receptor and microRNA-125b expression[J]. Proc Natl Acad Sci U S A, 2014, 111(8): 3008-3013.
[17] Narkwichean A, Jayaprakasan K, Maalouf WE, et al. Effects of dehydroepiandrosterone on in vivo ovine follicular development[J]. Hum Reprod, 2014, 29(1): 146-154.
[18] Li J, Yuan H, Chen Y, et al. A meta-analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection[J]. Int J Gynaecol Obstet, 2015, 131(3): 240-245.
[19] Nagels HE, Rishworth JR, Siristatidis CS, et al. Androgens(dehydroepiandrosterone or testosterone)for women undergoing assisted reproduction[J]. Cochrane Database Syst Rev, 2015(11): CD009749. doi: 10.1002/14651858.CD009749.pub2.
[20] Gat I, Blanco Mejia S, Balakier H, et al. The use of coenzyme Q10 and DHEA during IUI and IVF cycles in patients with decreased ovarian reserve[J]. Gynecol Endocrinol, 2016, 32(7): 534-537.
[21] Reynolds KA, Omurtag KR, Jimenez PT, et al. Cycle cancellation and pregnancy after luteal estradiol priming in women defined as poor responders: a systematic review and meta-analysis[J]. Hum Reprod, 2013, 28(11): 2981-2989.
[22] Buyuk E, Seifer DB, Illions E, et al. Elevated body mass index is associated with lower serum anti-mullerian hormone levels in infertile women with diminished ovarian reserve but not with normal ovarian reserve[J]. Fertil Steril, 2011, 95(7): 2364-2368.
[23] Vural F, Vural B, Cakiroglu Y. The role of overweight and obesity in In Vitro Fertilization outcomes of poor ovarian responders[J]. Biomed Res Int, 2015, 2015: 781543. doi: 10.1155/2015/781543.
[24] Selesniemi K, Lee HJ, Muhlhauser A, et al. Prevention of maternal aging-associated oocyte aneuploidy and meiotic spindle defects in mice by dietary and genetic strategies[J]. Proc Natl Acad Sci U S A, 2011, 108(30): 12319-12324.
[25] Simchen MJ, Yinon Y, Moran O, et al. Pregnancy outcome after age 50[J]. Obstet Gynecol, 2006, 108(5): 1084-1088.
[26] Klitzman RL. How old is too old? Challenges faced by clinicians concerning age cutoffs for patients undergoing in vitro fertilization[J]. Fertil Steril, 2016, 106(1): 216-224.
[27] Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion[J]. Fertil Steril, 2016, 106(5): e3-e7.
[1] 康晓菲,方跃艳,赵迪,冯秀娟,厉萍. 不孕女性患者知觉压力在正念水平与心理困扰间的中介作用[J]. 山东大学学报（医学版）, 2017, 55(9): 105-109.
[2] 李梅. 高龄女性的卵子和胚胎质量[J]. 山东大学学报（医学版）, 2017, 55(1): 16-21.
[3] 陈子江. “二孩”生育政策后再生育的临床思考[J]. 山东大学学报（医学版）, 2017, 55(1): 1-4.
[4] 邓晓惠,徐亚瑄. 高龄女性生育力评估及辅助生育[J]. 山东大学学报（医学版）, 2017, 55(1): 5-10.
[5] 朱依敏. 高龄辅助生育技术子代出生缺陷及认知障碍的风险[J]. 山东大学学报（医学版）, 2017, 55(1): 11-15.
[6] 杨冬梓,麦卓瑶. 高龄多囊卵巢综合征患者的卵巢储备特点及其助孕结局[J]. 山东大学学报（医学版）, 2017, 55(1): 26-32.
[7] 刘胜厚, 王韶进, 刘文广, 殷庆丰, 赵恒, 肖士鹏. 国产WagnerSL假体置换治疗高龄EvansⅢ型粗隆间骨折的疗效分析[J]. 山东大学学报（医学版）, 2015, 53(8): 49-52.
[8] 王红燕, 王燕蓉, 徐仙, 赵君利, 哈灵侠, 贾韶彤, 刘春莲. 改良的玻璃化液冻存乳鼠卵巢异体原位移植后生殖功能的恢复[J]. 山东大学学报（医学版）, 2014, 52(11): 27-32.
[9] 哈灵侠, 李向红. 多囊卵巢综合征患者卵泡液中GDF9和BMP15的表达及意义[J]. 山东大学学报（医学版）, 2014, 52(10): 77-80,95.
[10] 鹿群，沈浣，王丛，郑兴邦，陈曦，梁蓉,魏丽惠. 脱氢表雄酮对卵巢反应不良患者体外受精-胚胎移植的影响[J]. 山东大学学报(医学版), 2013, 51(2): 84-.
[11] 范玲玲，颜军昊，李媛，高芹，陈子江. 大Y染色体对体外受精-胚胎移植结局的影响[J]. 山东大学学报(医学版), 2010, 48(4): 15-.
[12] 常福丽，李淑玲，李育竹
. 益肾助孕颗粒治疗排卵障碍性
不孕症的临床研究[J]. 山东大学学报(医学版), 2009, 47(02): 82-84.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发