Wang Y A, Healy D, Black D, Sullivan E A
Perinatal and Reproductive Epidemiology Research Unit, School of Women's and Children's Health, The University of New South Wales, McNevin Dickson Building, Randwick Hospitals Campus, Randwick, NSW 2031, Australia.
Hum Reprod. 2008 Jul;23(7):1633-8. doi: 10.1093/humrep/den135. Epub 2008 Apr 26.
Woman's age is an independent factor determining the success of assisted reproductive technology treatment. This study presents the age-specific success rate of first autologous fresh treatment in Australia during 2002-2005.
This is a retrospective population-based study of 36,412 initiated first autologous fresh cycles conducted in Australian clinics during 2002-2005. Pregnancy and live delivery rates per initiated cycle were determined for each age.
The overall live delivery rate per initiated cycle was 20.4% with the highest success rate in women aged between 22 and 36 years. Male factor only infertility had a higher live delivery rate (22.0%) than female factor only infertility (19.2%). Advancing woman's age was associated with a decline in success rate. For women > or = 30 years, each additional 1 year in age was associated with an 11% (99% CI: 10-12%) reduction in the chance of achieving pregnancy and a 13% (99% CI: 12-14%) reduction in the chance of a live delivery. If women aged 35 years or older would have had their first autologous fresh treatment 1 year earlier, 15% extra live deliveries would be expected.
This study suggested that women aged 35 years or older should be encouraged to seek early fertility assessment and treatment where clinically indicated.
女性年龄是决定辅助生殖技术治疗成功与否的一个独立因素。本研究呈现了2002年至2005年期间澳大利亚首次自体新鲜胚胎移植治疗按年龄划分的成功率。
这是一项基于人群的回顾性研究，研究对象为2002年至2005年期间在澳大利亚诊所进行的36412个首次自体新鲜胚胎移植周期。确定每个年龄组每个启动周期的妊娠率和活产率。
每个启动周期的总体活产率为20.4%，22至36岁女性的成功率最高。单纯男性因素不孕的活产率（22.0%）高于单纯女性因素不孕（19.2%）。女性年龄增长与成功率下降相关。对于30岁及以上的女性，年龄每增加1岁，怀孕几率降低11%（99%CI：10 - 12%），活产几率降低13%（99%CI：12 - 14%）。如果35岁及以上的女性能提前1年进行首次自体新鲜胚胎移植治疗，预计活产率将额外提高15%。
本研究表明，35岁及以上的女性在临床指征明确时应被鼓励尽早寻求生育能力评估和治疗。
