Perinatal and Reproductive Epidemiology Research Unit, University of New South Wales, Sydney, Australia.
Hum Reprod. 2012 Jan;27(1):118-25. doi: 10.1093/humrep/der359. Epub 2011 Nov 2.
In recent years, particularly in developed countries, women have tended to delay childbirth until over 40 years of age. Our study aims to identify whether the donor's age or recipient's age influences the pregnancy and live birth rate following oocyte recipient cycles.
A population study included 3889 fresh oocyte recipient cycles. Pregnancy and live delivery rates were compared in recipient age groups (<35, 35-39, 40-44 and ≥45 years) and donor age groups (<30, 30-34, 35-39 and ≥40 years).
The highest live birth rate was of cycles in donors aged 30-34 years (25.0%), it decreased (P< 0.05) to 24.1% in donors aged <30 years, 20.7% in donors aged 35-39 years and 11.5% in donors aged ≥40 years. The multivariate analysis showed no significant differences in the success by recipient's age. Compared with cycles in donors aged 30-34 years, cycles in donors aged 35-39 years had 14 and 18% less chance to achieve a pregnancy [adjusted rate ratio (ARR) 0.86, 95% confidence interval (CI) 0.75-0.98] and a live delivery (ARR 0.82, 95% CI 0.71-0.96), while cycles in donors aged 40 years or older had 42 and 54% less chance to achieve a pregnancy (ARR 0.58, 95% CI 0.41-0.84) and a live delivery (ARR 0.46, 95% CI 0.29-0.73).
Older recipients with younger donors did not have a poorer pregnancy outcome compared with younger recipients with younger donors. Choosing a donor aged <35 years would increase the chance of pregnancy and live delivery for older recipients.
近年来,尤其是在发达国家,女性倾向于推迟到 40 岁以上生育。我们的研究旨在确定供卵者年龄或受卵者年龄是否会影响卵母细胞受者周期的妊娠和活产率。
一项人群研究纳入了 3889 例新鲜卵母细胞受者周期。比较了受卵者年龄组(<35 岁、35-39 岁、40-44 岁和≥45 岁)和供卵者年龄组(<30 岁、30-34 岁、35-39 岁和≥40 岁)的妊娠和活产率。
供卵者年龄在 30-34 岁的周期活产率最高(25.0%),<30 岁时下降(P<0.05)至 24.1%,35-39 岁时降至 20.7%,≥40 岁时降至 11.5%。多变量分析显示,受卵者年龄对成功率无显著差异。与供卵者年龄在 30-34 岁的周期相比,供卵者年龄在 35-39 岁的周期妊娠的可能性降低了 14%(调整后的比率比(ARR)为 0.86,95%置信区间(CI)为 0.75-0.98),活产的可能性降低了 18%(ARR 为 0.82,95%CI 为 0.71-0.96),而供卵者年龄在 40 岁或以上的周期妊娠的可能性降低了 42%(ARR 为 0.58,95%CI 为 0.41-0.84),活产的可能性降低了 54%(ARR 为 0.46,95%CI 为 0.29-0.73)。
与年轻供卵者的年轻受卵者相比,年龄较大的受卵者与年轻供卵者结合并不具有较差的妊娠结局。选择年龄<35 岁的供卵者会增加年龄较大的受卵者妊娠和活产的机会。