Subrat Panda, Santa Singh A, Vandana Jha
Department of Obstetrics and Gynaecology, NEIGRIHMS, Shillong, India.
J Reprod Infertil. 2013 Jan;14(1):3-7.
Apparent rise in the incidence of infertility in females and the trend shifting towards delayed child bearing brought up the concept of ovarian ageing. Women in their early thirties show poor ovarian reserve which is an entity named as early ovarian ageing. Early ovarian ageing is mostly genetically determined, but acquired modifiable factors like smoking, or ovarian surgery have some roles. Infertility and subfertility are the only clinical recognizable sequelae in the early ovarian ageing. The worrisome fact is that the outcome of assisted reproductive techniques is also not that much encouraging. Even if ovarian priming with DHEA has raised hope in the assisted reproductive techniques for these patients, but more randomized trials are needed to support this. Screening of these women with antimullerian hormone, antral follicle count and genetic analysis may be useful for recommendation at appropriate biological time regarding conception or fertility preservation.
女性不孕发病率的明显上升以及生育年龄推迟的趋势引出了卵巢衰老的概念。三十出头的女性卵巢储备功能较差,这一情况被称为早期卵巢衰老。早期卵巢衰老大多由基因决定,但诸如吸烟或卵巢手术等后天可改变的因素也有一定影响。不孕和生育力低下是早期卵巢衰老仅有的临床可识别后果。令人担忧的是,辅助生殖技术的效果也不太乐观。即便使用脱氢表雄酮进行卵巢预处理给这些患者的辅助生殖技术带来了希望,但仍需要更多随机试验来证实这一点。用抗苗勒管激素、窦卵泡计数和基因分析对这些女性进行筛查,可能有助于在合适的生理时机就受孕或生育力保存给出建议。