IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Centre, Tel-Hashomer, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Reprod Biomed Online. 2009 Oct;19(4):599-603. doi: 10.1016/j.rbmo.2009.04.002.
Women's fertility progressively declines with advanced age due to depletion of the ovarian follicular reserve and poorer oocyte quality. However, many women of advanced age are eager to conceive from their own ova. The aim of the present study was to evaluate the outcome of IVF cycles among older patients. All IVF retrievals performed in the unit in patients >or=42 years old between 1998 and 2006 were retrospectively analysed. Data were compared with patients <35 years old treated in the unit during the same time period. A total of 843 IVF retrievals in 459 patients >or=42 years old were assessed. Clinical pregnancy rates per cycle were 7.7%, 5.4% and 1.9% for 42, 43 and 44 years old, respectively. Only one IVF cycle in patients aged 44 years resulted in delivery. None of the 54 cycles performed in women of 45 years or older resulted in a pregnancy. A marked decline in clinical pregnancy and delivery rates, accompanied by an increase in spontaneous abortion rates, was found in patients >or=42 years old. In view of these results and as the option of egg donation is a promising alternative with delivery rates close to 50%, it appears that IVF treatment should be limited to patients not older than 43 years old with adequate ovarian response.
由于卵巢卵泡储备的减少和卵子质量较差，女性的生育能力会随着年龄的增长而逐渐下降。然而，许多高龄女性渴望用自己的卵子受孕。本研究旨在评估高龄患者的 IVF 周期结局。对 1998 年至 2006 年期间本单位年龄>42 岁的患者进行的所有 IVF 取卵进行回顾性分析。将数据与同期本单位治疗的<35 岁患者进行比较。共评估了 459 名年龄>42 岁的 843 例 IVF 取卵。42、43 和 44 岁患者的每周期临床妊娠率分别为 7.7%、5.4%和 1.9%。仅在 44 岁的患者中进行的一个 IVF 周期导致了分娩。在年龄为 45 岁或以上的女性中进行的 54 个周期均未导致怀孕。在年龄>42 岁的患者中，临床妊娠率和分娩率明显下降，同时自然流产率上升。鉴于这些结果，并且由于卵母细胞捐赠是一种很有前途的选择，其分娩率接近 50%，因此似乎应将 IVF 治疗限制在卵巢反应良好的不超过 43 岁的患者。
