Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (6): 35-39.doi: 10.6040/j.issn.1671-7554.0.2022.0082

Previous Articles    

Pregnancy outcomes of in vitro fertilization-intracytoplasmic sperm injection-embryo transfer in women 40 years and above

WU Richao1, LIU Hong1, WANG Ze1, GAO Shanshan1, LI Xiufang1, SHI Yuhua1,2   

  1. 1. Department of Reproductive Medicine, Center for Reproductive Medicine, Shandong University, Jinan 250021, Shandon, china;
    2. Department of Reproductive Medicine, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China
  • Published:2022-06-17

PDF (PC)

62

Abstract: Objective To investigate the pregnancy outcomes in women 40 years and older who underwent in vitro fertilization and intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET). Methods From January 2017 to December 2019, 4 914 cycles of non-donor IVF/ICSI-ET performed in the Reproductive Hospital Affiliated to Shandong University were retrospectively analyzed. The women were divided into 5 groups according to their age: 40-year-old group(n=1 243), 41-year-old group(n=1 045), 42-year-old group(n=976), 43-year-old group(n=718), and ≥44-year-old group(n=932). The clinical characteristics and pregnancy outcomes were compared and analyzed. Results A total of 2,212 cycles were transplanted, 512 of which obtained clinical pregnancy, with a clinical pregnancy rate of 23.1%. The clinical pregnancy rate in the groups was 35.7%, 26.4%, 21.1%, 10.5% and 9.7%, respectively; the miscarriage rate was 39.5%, 47.8%, 49.5%, 54.8% and 67.6%, respectively; the live birth rate was 21.6%, 13.4%, 10.7%, 4.7% and 3.1%, respectively, with statistically significant differences(P<0.001; P=0.020; P<0.001). Conclusion The ovarian function of women aged 40 and above decreases, and the outcome of in vitro assisted pregnancy is poor. The fertility of these women should be comprehensively evaluated to tailor individualized treatment.

Key words: In vitro fertilization-intracytoplasmic sperm injection-embryo transfer, Elderly women, Fertility, Pregnancy outcome

CLC Number: 

  • R714.8
[1] 沈浣, 罗旭飞, 吴丹.《中国高龄不孕女性辅助生殖临床实践指南》解读[J]. 实用妇产科杂志, 2020, 36(5): 350-353.
[2] Li F, Niu A, Feng X, et al. The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology [J]. Sci Rep, 2021, 11(1): 11368. doi:10.1038/s41598-021-90970-5.
[3] Christodoulaki A, Boel A, Tang M, et al. Prospects of germline nuclear transfer in women with diminished ovarian reserve [J]. Front Endocrinol(Lausanne), 2021, 12: 635370. doi: 10.3389/fendo.2021.635370.
[4] Wyns C, De Geyter C, Calhaz-Jorge C, et al. ART in Europe, 2017: results generated from European registries by ESHRE [J]. Hum Reprod Open, 2021, 2021(3): hoab026. doi: 10.1093/hropen/hoab026.
[5] Hu L, Bu Z, Huang G, et al. Assisted reproductive technology in China: results generated from data reporting system by CSRM from 2013 to 2016 [J]. Front Endocrinol(Lausanne), 2020, 11: 458. doi: 10.3389/fendo.2020.00458.
[6] Seshadri S, Morris G, Serhal P, et al. Assisted conception in women of advanced maternal age [J]. Best Pract Res Clin Obstet Gynaecol, 2021, 70: 10-20. doi: 10.1016/j.bpobgyn.2020.06.012.
[7] Harris BS, Steiner AZ, Jukic AM. Ovarian reserve biomarkers and menstrual cycle length in a prospective cohort tudy [J]. J Clin Endocrinol Metab, 2021, 106(9): e3748-e3759.
[8] Robertson DM, Lee CH, Baerwald A. Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age [J]. Endocrinol Diabetes Metab, 2020, 4(2): e00172. doi: 10.1002/edm2.172.
[9] Moolhuijsen LME, Visser JA. Anti-Müllerian hormone and ovarian reserve: update on assessing ovarian function [J]. J Clin Endocrinol Metab, 2020, 105(11): 3361-3373.
[10] Wang L, Lv S, Mao W, et al. Fecundity disorders in older women: declines in follicular development and endometrial receptivity [J]. BMC Womens Health, 2020, 20(1): 115. doi:10.1186/s12905-020-00979-7.
[11] Huang Y, Tu M, Qian Y, et al. Age-dependent metabolomic profile of the follicular fluids from women undergoing assisted reproductive technology treatment [J]. Front Endocrinol(Lausanne), 2022, 13: 818888. doi: 10.3389/fendo.2022.818888.
[12] Ma JY, Li S, Chen LN, et al. Why is oocyte aneuploidy increased with maternal aging? [J]. J Genet Genomics, 2020, 47(11): 659-671.
[13] Thomas C, Cavazza T, Schuh M. Aneuploidy in human eggs: contributions of the meiotic spindle [J]. Biochem Soc Trans, 2021, 49(1): 107-118.
[14] Reig A, Franasiak J, Scott RT Jr, et al. The impact of age beyond ploidy: outcome data from 8175 euploid single embryo transfers [J]. J Assist Reprod Genet, 2020, 37(3): 595-602.
[15] Mikwar M, MacFarlane AJ, Marchetti F. Mechanisms of oocyte aneuploidy associated with vanced maternal age [J]. Mutat Res Rev Mutat Res, 2020, 785: 108320. doi: 10.1016/j.mrrev.2020.108320.
[16] Zhang X, Fan J, Chen Y, et al. Cytogenetic analysis of the products of conception after spontaneous abortion in the first trimester [J]. Cytogenet Genome Res, 2021, 161(3-4): 120-131.
[17] Wartosch L, Schindler K, Schuh M, et al. Origins and mechanisms leading to aneuploidy in human eggs [J]. Prenat Diagn, 2021, 41(5): 620-630.
[18] Hassold T, Maylor-Hagen H, Wood A, et al. Failure to recombine is a common feature of human oogenesis [J]. Am J Hum Genet, 2021, 108(1): 16-24.
[19] Kimelman D, Pavone ME. Non-invasive prenatal testing in the context of IVF and PGT-A [J]. Best Pract Res Clin Obstet Gynaecol, 2021, 70: 51-62. doi:10.1016/j.bpobgyn.2020.07.004.
[20] Yan J, Qin Y, Zhao H, et al. Live birth with or without preimplantation genetic testing for aneuploidy [J]. N Engl J Med, 2021, 385(22): 2047-2058.
[21] Polanski LT, Baumgarten M. Endometrial Receptivity Testing and Therapy in Assisted Reproductive Treatment [J]. Semin Reprod Med, 2021, 39(1-02): 27-33.
[22] Neykova K, Tosto V, Giardina I, et al. Endometrial receptivity and pregnancy outcome [J]. J Matern Fetal Neonatal Med, 2020, 2: 1-15. doi: 10.1080/14767058.2020.1787977.
[23] Gao G, Cui X, Li S, et al. Endometrial thickness and IVF cycle outcomes: a meta-analysis [J]. Reprod Biomed Online, 2020, 40(1): 124-133.
[24] Wang X, Zhang Y, Sun HL, et al. Factors affecting artificial insemination pregnancy outcome [J]. Int J Gen Med, 2021, 14: 3961-3969. doi: 10.2147/IJGM.S312766.
[25] Shalom-Paz E, Atia N, Atzmon Y, et al. The effect of endometrial thickness and pattern on the success of frozen embryo transfer cycles and gestational age accuracy [J]. Gynecol Endocrinol, 2021, 37(5): 428-432.
[26] Shaodi Z, Qiuyuan L, Yisha Y, et al. Analysis of endometrial thickness threshold and optimal thickness interval in cleavage embryo hormone replacement freeze-thawed embryo transfer(HRT-FET)[J]. Gynecol Endocrinol, 2020, 36(11): 968-972.
[27] Bouzaglou A, Aubenas I, Abbou H, et al. Pregnancy at 40 years old and above: obstetrical, fetal, and neonatal outcomes. Is age an independent risk factor for those complications? [J]. Front Med(Lausanne), 2020, 7: 208. doi: 10.3389/fmed.2020.00208.
[28] Vandekerckhove M, Guignard M, Civadier MS, et al. Impact of maternal age on obstetric and neonatal morbidity: a retrospective cohort study [J]. BMC Pregnancy Childbirth, 2021, 21(1): 732. doi: 10.1186/s12884-021-04177-7.
[1] YANG Congpin, LUO Zhuoye, XU Xiuhua, LI Aimin, HAO Guimin. Reproductive choices and pressure in 3,512 women of childbearing age in a hospital in Hebei Province [J]. Journal of Shandong University (Health Sciences), 2022, 60(4): 62-67.
[2] Jing SHAN,Xiaoqiu WANG,Dajin LI. Molecular mechanisms of NK cells involved in endometriosis and its associated infertility [J]. Journal of Shandong University (Health Sciences), 2021, 59(8): 8-13.
[3] WU Xiaolin, LI Ping. Effect of Gn stimulation duration on pregnancy outcome of IVF-ET in long GnRHa protocol [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 32-37.
[4] ZHU Xuli, ZHOU Liang, WANG Yue, SUN Qingyun, CAO Mingya, DU Yuanjie, CAO Jinfeng, ZHAO Zhiming, HAO Guimin. Correlation analysis of freezing methods with different sperm sources and pregnancy outcomes [J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 86-93.
[5] LIANG Yanchun, YE Haihua, LU Limei, DAI Yujing, CHENG Qianyi, CHOI Unleng, ZENG Hanqiu, CHEN Xinghuan, WANG Xing, WEI Yajing, YANG Ruyu. Effects of chronic endometritis on the pregnancy outcomes of patients with endometriosis-associated infertility [J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 55-59.
[6] BAI Lu, ZHANG Yuqing, FANG Yuying. Infertility stress and posttraumatic stress disorder in infertile women: mindfulness as a mediator and moderator [J]. Journal of Shandong University (Health Sciences), 2021, 59(2): 83-87.
[7] LYU Yan, YU Xiao, LIN Xinying, ZHAO Qi, WANG Baozhen. Association between dietary patterns and depressive symptoms among Chinese elderly women [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 103-108.
[8] SHI Yuhua, LI Jing. Strategies for infertility treatment in elderly women [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 22-25.
[9] DENG Xiaohui, XU Yaxuan. Fertility evaluation and assisted reproduction in elder women [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 5-10.
[10] CHEN Zijiang. Clinical concern of the second pregnancy under the two-child policy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 1-4.
[11] XI Xianghong, SU Rong, JIA Shaotong, TANG Xiuying, WANG Lixin. Correlation between human epididymis protein 4 in seminal plasma and male infertility [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 66-69.
[12] LI Qi, SUN Yixin, LI Yixue, ZHANG Cuiqin, WU Rongshan, XUE Fuzhong. Spacial distribution of fertility rate in Shandong Province and its influencing factors [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(12): 107-112.
[13] WANG Likui, SANG Hongai, MA Yuyan, XU Yintao, WANG Linlin. Clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus: a study of 66 cases with 67 pregnancies [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(12): 69-72.
[14] . Effect of systematic prenatal health education and appropriate 
prenatal diagnosis on pregnancy outcome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(9): 134-136.
[15] CHANG Fuli，LI Shuling ， LI Yuzhu
. Kidneybenefiting and conceptionaiding granules in treating infertility due to ovulatory dysfunction [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(02): 82-84.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd