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)

699

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] 万文静,高姗姗. 低分子肝素在生殖领域的应用[J]. 山东大学学报 (医学版), 2025, 63(6): 117-124.
[2] 张扬,刘帅,邓明铭,王秋敏,黄玉真,颜磊. 宫腔镜子宫内膜息肉切除至取卵的时间间隔对IVF/ICSI鲜胚移植妊娠结局的影响[J]. 山东大学学报 (医学版), 2025, 63(10): 80-88.
[3] 刘雯,冯文娟,杨阳,纪昌丽,晁岚. 体质量指数对卵巢正常反应患者累积分娩率的影响[J]. 山东大学学报 (医学版), 2024, 62(3): 54-60.
[4] 赵圣蕊,曲慧灵,许鑫鑫,张芳芳,颜磊. 体外受精/卵胞浆内单精子注射-胚胎移植后稽留流产采用药物流产和清宫术效果比较[J]. 山东大学学报 (医学版), 2024, 62(2): 69-74.
[5] 王玉淼,崔晓霈,张红雨. 高龄老年新型冠状病毒肺炎患者应用抗凝治疗的短期疗效和安全性[J]. 山东大学学报 (医学版), 2024, 62(12): 21-31.
[6] 许月明,张杰,姜蕾,尹力,赵畔,许欣,郝桂敏. 扳机日孕酮升高与获卵数对辅助生殖技术新鲜周期妊娠结局的影响[J]. 山东大学学报 (医学版), 2023, 61(5): 44-50.
[7] 王园园,孙云. 合并新型冠状病毒肺炎的维持性血液透析患者死亡危险因素[J]. 山东大学学报 (医学版), 2023, 61(11): 68-73.
[8] 慈倩倩,武胜英,万秋花,马运荣,赵建文,张健. 10 265例高龄孕妇的产前筛查与诊断方法分析[J]. 山东大学学报 (医学版), 2023, 61(1): 51-57.
[9] 鹿群,赵璐璐. 子宫内膜癌、子宫内膜非典型增生保留生育功能后助孕策略[J]. 山东大学学报 (医学版), 2022, 60(9): 35-41.
[10] 冷金花, 史精华. 子宫腺肌病的临床表现[J]. 山东大学学报 (医学版), 2022, 60(7): 1-5.
[11] 颜磊,陈子江. 子宫腺肌病合并不孕的治疗[J]. 山东大学学报 (医学版), 2022, 60(7): 43-47.
[12] 吴日超,刘红,王泽,高姗姗,李秀芳,石玉华. 40岁及以上女性行体外受精-胚胎移植助孕的妊娠结局分析[J]. 山东大学学报 (医学版), 2022, 60(6): 35-39.
[13] 韩晓婷,高文丽,王婷,赵君利. 扳机日及其后添加重组人促黄体激素对黄体期长方案助孕结局的影响[J]. 山东大学学报 (医学版), 2022, 60(12): 31-38.
[14] 单婧,王晓秋,李大金. NK细胞参与子宫内膜异位症及其不孕的分子机制[J]. 山东大学学报 (医学版), 2021, 59(8): 8-13.
[15] 邓晓惠,郭玲. 免疫治疗在胚胎反复种植失败中的应用进展[J]. 山东大学学报 (医学版), 2021, 59(8): 32-37.
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