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40岁及以上女性辅助生殖技术后成功妊娠的预测因素。

Predictive factors of successful pregnancy after assisted reproductive technology in women aged 40 years and older.

作者信息

Fujimoto Akihisa, Fujiwara Toshihiro, Oishi Hajime, Hirata Tetsuya, Yano Tetsu, Taketani Yuji

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine University of Tokyo 7-3-1 Hongo, Bunkyo-ku 113-8655 Tokyo Japan.

Reproduction Center International University of Health and Welfare 8-10-16 Akasaka, Minato-ku 107-0052 Tokyo Japan.

出版信息

Reprod Med Biol. 2009 Jul 18;8(4):145-149. doi: 10.1007/s12522-009-0023-z. eCollection 2009 Dec.

Abstract

PURPOSE

This study aimed to investigate the factors that predict successful pregnancy (live birth) in assisted reproductive technology (ART) for infertile women aged 40 and older.

METHODS

Patients who underwent first ART treatments at the age of 40 and older at our institution were enrolled. Several factors which can be evaluated before the first treatments were retrospectively compared among those patients who did and did not achieve live birth.

RESULTS

Nineteen of 119 patients delivered healthy babies. There was no significant difference of live-birth rate among age groups of 40, 41 and 42. No women who underwent the first treatment at age 43 or older achieved live birth. In the successful group, significantly more women held FSH levels under 12 mIU/ml and had regular menstrual cycles (26-32 days) than unsuccessful women of the same age group. In addition, significantly fewer women in the successful group had prior ovarian surgery.

CONCLUSIONS

Our results show that low FSH levels, regular menstrual cycles and absence of prior ovarian surgery were related to high live-birth rates and they are good prognostic factors in patients between 40 and 42 years of age. On the other hand, none of these parameters were correlated with success in women aged 43 and older.

摘要

目的

本研究旨在调查40岁及以上不孕女性在辅助生殖技术(ART)中预测成功妊娠(活产)的因素。

方法

纳入在我院接受首次ART治疗时年龄在40岁及以上的患者。对首次治疗前可评估的几个因素在活产和未活产的患者中进行回顾性比较。

结果

119例患者中有19例分娩出健康婴儿。40、41和42岁年龄组的活产率无显著差异。43岁及以上首次接受治疗的女性均未实现活产。在成功组中,与同年龄组未成功的女性相比,FSH水平低于12 mIU/ml且月经周期规律(26 - 32天)的女性明显更多。此外,成功组中既往有卵巢手术史的女性明显更少。

结论

我们的结果表明,低FSH水平、规律的月经周期以及无既往卵巢手术史与高活产率相关,它们是40至42岁患者的良好预后因素。另一方面,这些参数均与43岁及以上女性的成功无关。

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