Yoldemir T
a Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology and Infertility , Marmara University School of Medicine , Istanbul , Turkey.
Climacteric. 2016 Jun;19(3):240-6. doi: 10.3109/13697137.2016.1164133. Epub 2016 Apr 21.
Reduced maternal fertility is the consequence of depletion of follicles with maternal aging. In a 35-year-old woman, approximately 9.1% of the residual follicle pool disappears annually without entering into the growing stage, whereas, in a 45-year-old woman, this number triples. After the age of 35 years, the frequency of aneuploidies in oocytes increases sharply. Roughly 50-70% of mature oocytes from a 40-year-old woman have chromosomal abnormalities. The clinical pregnancy and implantation rates are lower in midlife women. Various controlled ovarian stimulation interventions have been suggested for the management of women in advanced age, most of whom are likely to be poor-responder patients. Currently, systematic reviews and meta-analyses suggest that there is insufficient evidence to recommend most of the treatments proposed to improve pregnancy rates in these poor responders. Minimal stimulation or natural cycle in vitro fertilization may be offered, without compromising the already existing pregnancy results.
随着母亲年龄增长，卵泡耗竭会导致母亲生育能力下降。在35岁的女性中，每年约有9.1%的残余卵泡池未进入生长阶段就消失了，而在45岁的女性中，这一数字增至三倍。35岁之后，卵母细胞非整倍体的发生率急剧上升。40岁女性的成熟卵母细胞中约有50%-70%存在染色体异常。中年女性的临床妊娠率和着床率较低。对于高龄女性的治疗，已经提出了各种控制性卵巢刺激干预措施，其中大多数可能是低反应患者。目前，系统评价和荟萃分析表明，没有足够的证据推荐大多数为提高这些低反应患者妊娠率而提出的治疗方法。可以采用最小刺激或自然周期体外受精，同时不影响现有的妊娠结果。
