影响生育力的因素及高龄生育的策略

doi:10.6040/j.issn.1671-7554.0.2018.1420

摘要/Abstract

摘要： 影响生育力的因素非常复杂,年龄增长是生育力下降最不可抗拒的因素,不良遗传、环境、精神心理、生活方式等因素的联合作用也会加速生育力的损害。随着科技的进步,已有多种生育力评估的指标,建议生育期男女尤其是高龄夫妇及时进行生育评估、排除妊娠相关风险,正确对待助孕技术、赠卵及助孕年龄上限。

关键词: 年龄, 生育力, 影响因素, 生育评估, 高龄生育, 体外助孕

Abstract: The factors that affecting fertility are very complex. Age growth is the most irresistible factor for fertility decline. Other factors, including heredity, environment, psychosocial status and lifestyle, also accelerate the damage of fertility. With the progress of science and technology, many indicators were employed for fertility assessment. It is suggested that men and women at childbearing age, especially elderly couples, should timely accept fertility assessment to eliminate pregnancy-related risks, and correctly choose assisted reproductive technology or egg donation, and understand the upper limit of ART age.

Key words: Age, Fertility, Influencing factors, Fertility assessment, Advanced age fertility, In vitro fertilization

中图分类号:

R711.6

孙梅,崔文娟. 影响生育力的因素及高龄生育的策略[J]. 山东大学学报 (医学版), 2019, 57(2): 23-28.

SUN Mei, CUI Wenjuan. Risk factors affecting fertility and strategies for advanced age fertility[J]. Journal of Shandong University (Health Sciences), 2019, 57(2): 23-28.

参考文献

[1] Gill SK, Broussard C, Devine O, et al. Association between maternal age and birth defects of unknown etiology: United States, 1997-2007[J]. Birth Defects Res Part A Clin Mol Teratol, 2012, 94(12): 1010-1018.
[2] Sharma R, Agarwal A, Rohra VK, et al. Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring[J]. Reprod Biol Endocrinol, 2015, 13: 35. doi:10.1186/s12958-015-0028-x.
[3] de La Rochebrochard E, de Mouzon J, Thépot F, et al. Fathers over 40 and increased failure to conceive: the lessons of in vitro fertilization in France[J]. Fertil Steril, 2006, 85(5): 1420-1424.
[4] Steiner AZ, Jukic AM. Impact of female age and nulligravidity on fecundity in an older reproductive age cohort[J]. Fertil Steril, 2016, 105(6): 1584-1588.
[5] De Vos M, Devroey P, Fauser BC. Primary ovarian insufficiency[J]. Lancet, 2010, 376(9744): 911-921.
[6] Franasiak JM, Forman EJ, Hong KH, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening[J]. Fertil Steril, 2014, 101(3): 656-663.
[7] Revel A. Defective endometrial receptivity[J]. Fertil Steril, 2012, 97(5): 1028-1032.
[8] Stone BA, Alex A, Werlin LB, et al. Age thresholds for changes in semen parameters in men[J]. Fertil Steril, 2013, 100(4): 952-958.
[9] Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study[J]. J Clin Endocrinol Metab, 2002, 87(2): 589-598.
[10] Broer L, Codd V, Nyholt DR, et al. Meta-analysis of telomere length in 19,713 subjects reveals high heritability, stronger maternal inheritance and a paternal age effect[J]. Eur J Hum Genet, 2013, 21(10): 1163-1168.
[11] Moskovtsev SI, Willis J, Mullen JB. Age-related decline in sperm deoxyribonucleic acid integrity in patients evaluated for male infertility[J]. Fertil Steril, 2006, 85(2): 496-499.
[12] Curley JP, Mashoodh R, Champagne FA. Epigenetics and the origins of paternal effects[J]. Horm Behav, 2011, 59(3): 306-314.
[13] Schimmel MS, Bromiker R, Hammerman C, et al. The effects of maternal age and parity on maternal and neonatal outcome[J]. Arch Gynecol Obstet, 2015, 291(4): 793-798.
[14] 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.
[15] Morris JK, Wald NJ, Mutton DE, et al. Comparison of models of maternal age-specific risk for Down syndrome live births[J]. Prenat Diagn, 2003, 23(3): 252-258.
[16] 章小维, 郭明彩, 杨慧霞. 高龄初产对妊娠结局的影响[J]. 中国实用妇科与产科杂志, 2005, 21(2): 111-112. ZHANG Xiaowei, GUO Mingcai, YANG Huixia. The effects of first pregnancy in elder age on the prognosis[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2005, 21(2): 111-112.
[17] Nybo Andersen AM, Urhoj SK. Is advanced paternal age a health risk for the offspring?[J] Fertil Steril, 2017, 107(2): 312-318.
[18] Chapman C, Cree L, Shelling AN. The genetics of premature ovarian failure: current perspectives[J]. Int J Womens Health, 2015, 7: 799-810. doi:10.2147/IJWH.S64024.
[19] 姜辉, 田杨, 黄锦, 等. 重视染色体基因缺陷对男性生育的影响[J]. 北京大学学报(医学版), 2012, 44(4): 504-506.
[20] Ramlau-Hansen CH, Thulstrup AM, Nohr EA, et al. Subfecundity in overweight and obese couples[J]. Hum Reprod, 2007, 22(6): 1634-1637.
[21] Chavarro JE, Rich-Edwards JW, Rosner BA, et al. Dietary fatty acid intakes and the risk of ovulatory infertility[J]. Am J Clin Nutr, 2007, 85(1): 231-237.
[22] Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence[J]. Hum Reprod Update, 2011, 17(1): 17-33.
[23] 卓胜楠, 张印峰, 张帅, 等. 不孕症女性体质量指数对IVF/ICSI-ET治疗结局的影响[J]. 生殖与避孕, 2013, 33(8): 534-540. ZHUO Shengnan, ZHANG Yinfeng, ZHANG Shuai, et al. Influence of body mass index on IVF/ICSI-ET treatment outcome among infertility women[J]. Reproduction and Contraception, 2013, 33(8): 534-540.
[24] 杨青萍. 卵巢储备功能与生育力减退影响因素的研究进展[J]. 医学综述, 2016, 22(11): 2158-2161. YANG Qingping. Research progress in the influence factors of ovarian reserve and fertility diminishment[J]. Medical Recapitulate, 2016, 22(11): 2158-2161.
[25] 白双勇,王剑松. 肥胖对男性精液影响的研究进展[J]. 医学综述, 2015, 21(17): 3087-3089. BAI Shuangyong, WANG Jiansong. Research progress in the effects of obesity on male semen[J]. Medical Recapitulate, 2015, 21(17): 3087-3089.
[26] Spandorfer SD, Kump L, Goldschlag D, et al. Obesity and in vitro fertilization: negative influences on outcome[J]. J Reprod Med, 2004, 49(12): 973-977.
[27] Zhang D, Zhu YM, Gao HJ, et al. Overweight and obesity negatively affect the outcomes of ovarian stimulation and in vitro fertilisation: a cohort study of 2628 Chinese women[J]. Gynecol Endocrinol, 2010, 26(5): 325-332.
[28] Colaci DS, Afeiche M, Gaskins AJ, et al. Mens body mass index in relation to embryo quality and clinical outcomes in couples undergoing in vitro fertilization[J]. Fertil Steril, 2012, 98(5): 1193-1199.
[29] Petríková J, Lazúrová I. Ovarian failure and polycystic ovary syndrome[J]. Autoimmun Rev, 2012, 11(6-7): A471-478.
[30] La Marca A, Brozzetti A, Sighinolfi G, et al. Primary ovarian insufficiency: autoimmune causes[J]. Curr Opin Obstet Gynecol, 2010, 22(4): 277-282.
[31] Toufexis D, Rivarola MA, Lara H, et al. Stress and the reproductive axis[J]. J Neuroendocrinol, 2014, 26(9): 573-586.
[32] Pal L, Bevilacqua K, Santoro NF. Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women[J]. J Psychosom Obstet Gynaecol, 2010, 31(3): 130-139.
[33] 倪少凯, 吴柱国, 黄建初, 等. 东莞市不孕不育影响因素的调查与分析[J]. 广东医学院学报, 2010, 28(4): 364-367. NI Shaokai, WU Zhuguo, HUANG Jianchu, et al. Influencing factors of infertility in Dongguan City[J]. Journal of Guangdong Medical College, 2010, 28(4): 364-367.
[34] Han Y, Xia YK, Zhu PF, et al. Reproductive hormones in relation to polycyclic aromatic hydrocarbon(PAH)metabolites among non-occupational exposure of males[J]. Sci Total Environ, 2010, 408(4): 768-773.
[35] Cohn BA, Cirillo PM, Sholtz RI, et al. Polychlorinated biphenyl(PCB)exposure in mothers and time to pregnancy in daughters[J]. Reprod Toxicol, 2011, 31(3): 290-296.
[36] Eskenazi B, Warner M, Marks AR, et al. Serum dioxin concentrations and time to pregnancy[J]. Epidemiology, 2010, 21(2): 224-231.
[37] Axmon A, Thulstrup AM, Rignell-Hydbom A, et al. Time to pregnancy as a function of male and female serum concentrations of 2,2'4,4'5,5'-hexachlorobiphenyl(CB-153)and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene(p,p'-DDE)[J]. Hum Reprod, 2006, 21(3): 657-665.
[38] Li DK, Zhou ZJ, Miao MH, et al. Urine bisphenol-A(BPA)level in relation to semen quality[J]. Fertil Steril, 2011, 95(2): 625-630.
[39] Wirth JJ, Rossano MG, Potter R, et al. A pilot study associating urinary concentrations of phthalate metabolites and semen quality[J]. Syst Biol Reprod Med, 2008, 54(3): 143-154.
[40] Herr C, zur Nieden A, Koch HM, et al. Urinary di(2-ethylhexyl)phthalate(DEHP): metabolites and male human markers of reproductive function[J]. Int J Hyg Environ Health, 2009, 212(6): 648-653.
[41] Lin CM, Chang WP, Doyle P, et al. Prolonged time to pregnancy in residents exposed to ionising radiation in cobalt-60-contaminated buildings[J]. Occup Environ Med, 2010, 67(3): 187-195.
[42] Kesari KK, Agarwal A, Henkel R. Radiations and male fertility[J]. Reprod Biol Endocrinol, 2018, 16(1): 118.
[43] Hjollund NH, Storgaard L, Ernst E, et al. Impact of diurnal scrotal temperature on semen quality[J]. Reprod Toxicol, 2002, 16(3): 215-221.
[44] 白婷, 肖红梅, 卢光琇. 不孕症患者病因调查分析[J]. 生命科学研究, 2008, 12(3): 267-271. BAI Ting, XIAO Hongmei, LU Guangxiu. Investigation on etiological factors of infertile couples[J]. Life Science Research, 2008, 12(3): 267-271.
[45] Li Y, Lin H, Li YF, et al. Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses[J]. Fertil Steril, 2011, 95(1): 116-123.
[46] Anifandis G, Bounartzi T, Messini CI, et al. The impact of cigarette smoking and alcohol consumption on sperm parameters and sperm DNA fragmentation(SDF)measured by Halosperm(®)[J]. Arch Gynecol Obstet, 2014, 290(4): 777-782.
[47] Lalinde-Acevedo PC, Mayorga-Torres BJM, Agarwal A, et al. Physically active men show better semen parameters than their sedentary counterparts[J]. Int J Fertil Steril, 2017, 11(3): 156-165.
[48] 高商, 袁聚祥, 韩宝生. 女性不孕相关危险因素的病例对照研究[J]. 中国妇幼保健, 2015, 30(18): 3014-3016. GAO Shang, YUAN Juxiang, HAN Baosheng. A case-control study on related risk factors of female infertility[J]. Maternal & Child Health Care of China, 2015, 30(18): 3014-3016.
[49] 李亚宁. 人工流产后不孕妇女的免疫学检查结果分析[J]. 医学与临床, 2011, 8(8): 970-971.
[50] 李晓梅. 高龄妇女再生育能力的孕前评估及干预措施[J]. 中国当代医药, 2018, 25(17): 29-32. LI Xiaomei. Pre-pregnancy assessment and intervention measures for the reproductive ability of elderly women[J]. China Modern Medicine, 2018, 25(17): 29-32.
[51] 孙瑜, 朱依敏. 高龄不育夫妇,现代辅助生殖技术之惑[J]. 中国计划生育和妇产科, 2014, 6(8): 1-3.
[52] 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.
[53] 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.
[54] Qiao J, Wang ZB, Feng HL, et al. The root of reduced fertility in aged women and possible therapentic options: current status and future perspects[J]. Mol Aspects Med, 2014, 38: 54-85. doi:10.1016/j.mam.2013.06.001.
[55] Ethics Committee of the American Society for Reproductive Medicine. Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion[J]. Fertil Steril, 2016, 106(5): e3-e7.doi:10.1016/j.Fertnstert.2016.07.002.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed