Gleicher Norbert, Weghofer Andrea, Barad David
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
J Assist Reprod Genet. 2007 Dec;24(12):639-44. doi: 10.1007/s10815-007-9182-1. Epub 2007 Dec 4.
In vitro fertilization (IVF) in women of advanced age (>42 years) represents only 5%, a comparatively minute part, of the national IVF experience in the United States (US). In view of evolving population dynamics, it, however, also represents proportionally a rather quickly expanding patient need. Because of access restrictions at many IVF programs, this market does not live up to its potential. As best demonstrated by the 2004 US National Summary and Fertility Clinic Report, which for the first time reported pregnancies and births above age 45 year, IVF in women of advanced reproductive age represents a cutting edge area of interest for improving current IVF outcomes. Access to IVF should, therefore, not be withheld based on female age and/or baseline FSH levels. Instead, a definition of acceptable minimal pregnancy and life birth rates could be used to define the limits of offered access to IVF, independent of age and/or baseline FSH levels.
高龄（>42岁）女性的体外受精（IVF）在美国全国IVF经验中仅占5%，是一个相对较小的部分。然而，鉴于不断变化的人口动态，按比例来说，这也代表着一种迅速扩大的患者需求。由于许多IVF项目存在准入限制，这个市场并未充分发挥其潜力。2004年美国国家总结与生育诊所报告首次报告了45岁以上的怀孕和分娩情况，这最能说明，高龄生殖年龄女性的IVF是改善当前IVF结果的一个前沿关注领域。因此，不应基于女性年龄和/或基础促卵泡激素（FSH）水平而拒绝提供IVF。相反，可以用可接受的最低妊娠率和活产率的定义来界定提供IVF的准入限制，而不受年龄和/或基础FSH水平的影响。
