Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Department of Neurology, University of California, San Francisco, California.
Fertil Steril. 2018 Jun;109(6):1051-1059. doi: 10.1016/j.fertnstert.2018.02.001.
To estimate the cumulative live birth rates (CLBRs) in women with poor ovarian response (POR) diagnosed according to the Bologna criteria.
A 15-year population-based observational cohort study.
Teaching hospital.
PATIENT(S): Between 2002 and 2016 a total of 3,391 women with POR were followed from their first fresh, nondonor IVF cycle until they had a live birth or discontinued treatment. All IVF and intracytoplasmic sperm injection (ICSI) cycles and cryocycles were included.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Live birth rates per initiated cycle, the conservative and optimistic CLBR for multiple IVF cycles.
RESULT(S): The CLBRs after six IVF cycles were 14.9% for the conservative and 35.3% for the optimistic estimate. The CLBR decreased from 22% for women ≤30 years to 18.3% for women aged 31-34 years, 17.2% for 35-37 years, 13.5% for 38-40 years, 10.5% for 41-43 years, and 4.4% among women >43 years in the conservative analysis. There was a significant decreased CLBR starting at age 38 years compared with women <35 years. After adjusting for age, antral follicle count, basal FSH level, and IVF cycle number, natural cycles were associated with the lowest CLBR among all the protocols, and this difference was significant compared with the other protocols.
CONCLUSION(S): For women with POR, the CLBR declined with increasing age. Women with advanced age (≥38 years) achieved a significantly lower CLBR than young poor responders (<35 years). Very low CLBR was associated with women aged >43 years old. Natural cycle IVF is of no benefit for these patients.
根据博洛尼亚标准，估计卵巢反应不良（POR）女性的累积活产率（CLBR）。
一项为期 15 年的基于人群的观察性队列研究。
教学医院。
2002 年至 2016 年间，共 3391 名 POR 患者接受了他们的首次新鲜、非捐赠 IVF 周期的随访，直到他们活产或停止治疗。所有 IVF 和胞浆内单精子注射（ICSI）周期和冷冻周期均包括在内。
无。
每启动周期的活产率、多次 IVF 周期的保守和乐观 CLBR。
保守估计下，第六个 IVF 周期后的 CLBR 为 14.9%，乐观估计下为 35.3%。CLBR 从≤30 岁的女性的 22%下降到 31-34 岁的女性的 18.3%、35-37 岁的女性的 17.2%、38-40 岁的女性的 13.5%、41-43 岁的女性的 10.5%和>43 岁的女性的 4.4%。在保守分析中，与<35 岁的女性相比，38 岁以上的女性 CLBR 显著下降。调整年龄、窦卵泡计数、基础 FSH 水平和 IVF 周期数后，自然周期与所有方案中最低的 CLBR 相关，与其他方案相比，这一差异具有统计学意义。
对于 POR 患者，CLBR 随年龄增长而下降。高龄（≥38 岁）患者的 CLBR 明显低于年轻 POR 患者（<35 岁）。非常低的 CLBR 与年龄>43 岁的女性有关。自然周期 IVF 对这些患者没有益处。
