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

doi:10.6040/j.issn.1671-7554.0.2022.0082

摘要/Abstract

摘要： 目的探讨40岁及以上女性行体外受精和胞浆内精子注射-胚胎移植(IVF/ICSI-ET)的妊娠结局。方法回顾性分析2017年1月至2019年12月在山东大学附属生殖医院行非供卵IVF/ICSI-ET的年龄≥40岁的女性患者的临床资料,共4 914个周期,按年龄分为5组:40岁组(n=1243)、41岁组(n=1045)、42岁组(n=976)、43岁组(n=718)、≥44岁组(n=932)。比较分析各组临床特征和助孕结局。结果在4 914个促排卵周期中,共2 212个周期实现移植,512个周期获得临床妊娠,临床妊娠率为23.1%。各组临床妊娠率分别为35.7%、26.4%、21.1% 、10.5%、9.7%,各组流产率分别为39.5%、47.8%、49.5%、54.8%、67.6%,各组活产率分别为21.6%、13.4%、10.7%、4.7%、3.1%。5组临床妊娠率、活产率、流产率差异均具有统计学意义(P<0.001;P=0.020;P<0.001)。结论 40岁及以上女性卵巢功能下降,体外助孕结局较差。对于≥40岁女性,临床上应全面评估其生育能力,选择个体化治疗。

关键词: 体外受精-胚胎移植, 高龄女性, 生育力, 妊娠结局

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

中图分类号:

R714.8

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.

WU Richao, LIU Hong, WANG Ze, GAO Shanshan, LI Xiufang, SHI Yuhua. Pregnancy outcomes of in vitro fertilization-intracytoplasmic sperm injection-embryo transfer in women 40 years and above[J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 35-39.

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