Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Reprod Biomed Online. 2012 Feb;24(2):170-3. doi: 10.1016/j.rbmo.2011.11.007. Epub 2011 Nov 20.
Fertility decreases with advancing age. This study retrospectively reviewed the results of ovarian stimulation and intrauterine insemination (IUI) in women 40 years old with diminished ovarian reserve or unexplained infertility who underwent treatment with ovarian stimulation/IUI with clomiphene citrate or gonadotrophin and compared them with the results of IVF and in-vitro maturation (IVM) treatments. The main outcome measures were pregnancy and live-birth rates. The profiles of the patients in ovarian stimulation, IVM and IVF groups were comparable. There were no clinical pregnancies in the clomiphene citrate and IVM groups. The clinical-pregnancy rates in the gonadotrophin and IVF groups were 2.6% and 16.9% and the live-birth rates were 2.6% and 13.7%, respectively. Compared with ovarian stimulation, IVF is most effective for women aged 40 years or more. Attempting success with ovarian stimulation or IVM will delay conception unnecessarily.
生育能力随年龄增长而下降。本研究回顾性分析了卵巢刺激和宫腔内人工授精（IUI）治疗卵巢储备功能减退或不明原因不孕且年龄 40 岁的女性的结果，这些女性接受了克罗米酚或促性腺激素治疗的卵巢刺激/IUI 治疗，并将结果与体外受精和体外成熟（IVM）治疗进行了比较。主要观察指标为妊娠率和活产率。卵巢刺激、IVM 和 IVF 组患者的特征相似。克罗米酚和 IVM 组均无临床妊娠。促性腺激素和 IVF 组的临床妊娠率分别为 2.6%和 16.9%，活产率分别为 2.6%和 13.7%。与卵巢刺激相比，体外受精对年龄在 40 岁及以上的女性最有效。尝试卵巢刺激或 IVM 成功会不必要地延迟受孕。
