摘要
目的 探讨≥40岁高龄女性多周期体外受精(in vitro fertilization,IVF)助孕的累积活产率及相关影响因素.方法 回顾性分析了2014年4月1日至2016年9月31日期间因不孕症在西北妇女儿童医院生殖中心首次行IVF/卵胞质内单精子显微注射(intracytoplasmic sperm injection,ICSI)助孕且年龄≥40岁的603例不孕症的临床资料.根据患者年龄的不同分为4组:A组(40~41岁)、B组(42~43岁)、C组(44~45岁)和D组(≥46岁).比较各组间基础卵泡数、产次、不孕因素、每移植周期活产率、多周期累积活产率等的差异,并对年龄、产次等对累积活产率的影响进行logistic多因素分析.结果 ①A组的每移植周期的妊娠率、每移植周期的活产率、多周期累积活产率较其他组高,差异具有统计学意义(P<0.05);②至少1个周期无获卵的占比随着年龄增加明显增加(P<0.001);③经历3个周期的IVF助孕后,年龄≥40岁开始进行IVF助孕的不孕症患者的累积活产率达到平台期.④Logistic多因素分析表明:与A组相比,B^D组累积活产率明显降低,OR值分别为0.416(95% CI=0.259~0.668)、0.227(95% CI=0.114~0.453)、0.121 (95% CI=0.036~0.410).结论 累积活产率随着年龄的增加而明显降低,在进行3个周期的IVF助孕后,累积活产率并不随着IVF周期数的增加而明显提高.
Objective To investigate the cumulative live birth rates(CLBRs)and related influencing factors in women aged≥40 years who underwent multi-cycle in vitro fertilization(IVF).Methods This was a retrospective study.A total of 603 patients aged≥40 years who underwent their first IVF cycle in the Center of Assisted Reproductive Technology of Northwest Women and Children’s Hospital enrolled from April 2014 to September 2016.Patients were categorized into four groups according to age:group A(40-41 years),group B(42-43 years),group C(44-45 years);and group D(≥46 years).The differences in antral follicle count(AFC),etiology of infertility and CLBR among the four groups were detailed compared.Some influencing factors related to CLBRs,such as age and parity,were also analyzed by logistic multivariate methods.Results The pregnancy rate per cycle,the live birth rates per cycle and the cumulative live birth rates were significantly higher in group A than those in other group,and the differences between the groups were statistically significant(P<0.05).However,the number of patients with at least one cycle with no retrieval oocytes significantly enhanced(P<0.001).After three IVF cycles,122 patients achieved a live birth,which comprised 97.6%of the total live births.Compared with group A,CLBR significantly declined from group B to group D.The OR values of groups(B,C to D)were 0.416(95%CI=0.259-0.668),0.227(95%CI=0.114-0.453)and 0.121(95%CI=0.036-0.410),respectively.Conclusion CLBR significantly declined with age.After three cycles of treatment,the accrual in the CLBR becomes less pronounced for all the four age groups.
作者
潘荣
师娟子
高明
Pan Rong;Shi Juanzi;Gao Ming(Center of Assisted Reproductive Technology,Northwest Women and Children’s Hospital,Xi’an 710003,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2020年第1期9-13,共5页
Chinese Journal of Reproduction and Contraception
基金
西安市科技局基金项目(2016052SF/YX08)。
关键词
高龄
累积活产率
受精
体外
Advanced age
Cumulative live birth rates
Fertilization in vitro
