Yin Huiqun, Jiang Hong, He Ruibing, Wang Cunli, Zhu Jie, Cao Zhenyi
Reproductive Medicine Center, 105th Hospital of the People's Liberation Army (PLA), 230031 Hefei, China.
Reproductive Medicine Center, 105th Hospital of the People's Liberation Army (PLA), 230031 Hefei, China.
Taiwan J Obstet Gynecol. 2019 Mar;58(2):201-205. doi: 10.1016/j.tjog.2019.01.006.
The aim of this study was to investigate cumulative live birth rate (CLBR) per oocyte retrieval cycle and per patient in women over 40 years old undergoing IVF/ICSI treatments, stratified for age, ovarian response and oocyte retrieval cycle number.
244 patients with poor ovarian response (POR) and 372 patients with normal ovarian response (NOR) were retrospectively investigated.
Of the patients aged 40 to 43 years, CLBR per oocyte retrieval cycle and per patient (4.3%; 8.8%) in POR group were both lower than those in NOR group (15.8%; 24.8%) (P < 0.01). No significant differences in live birth rate (LBR) per oocyte retrieval cycle or CLBR per patient were observed in the group of POR patients irrespective of oocyte retrieval cycles they underwent. Similarly, CLBR per patient in NOR group did not increase significantly with the oocyte retrieval cycle number. However, LBR per oocyte retrieval cycle in the first cycle (Cycle 1, 20.3%) was significantly higher than that in the second cycle (Cycle 2, 9.2%) and the third cycle (Cycle 3, 4.4%) (P < 0.01). And 94.8% (73/77) of live births were achieved during the first two cycles. Of the patients aged 44 to 45 years and over 45 years old, there were no significant differences in CLBR per oocyte retrieval cycle or per patient between POR and NOR groups.
Relatively higher cumulative live birth rate was only found in the patients aged 40 to 43 years without poor ovarian response. These findings may provide some information that further sub-classification of advance-age women according to ovarian response may help both clinicians and patients to balance decision-making about their infertility treatment.
本研究旨在调查40岁以上接受体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗的女性每个取卵周期及每位患者的累积活产率(CLBR),并按年龄、卵巢反应和取卵周期数进行分层。
对244例卵巢反应不良(POR)患者和372例卵巢反应正常(NOR)患者进行回顾性研究。
40至43岁的患者中,POR组每个取卵周期及每位患者的CLBR(分别为4.3%;8.8%)均低于NOR组(分别为15.8%;24.8%)(P<0.01)。无论POR患者接受的取卵周期数如何,其每个取卵周期的活产率(LBR)或每位患者的CLBR均未观察到显著差异。同样,NOR组每位患者的CLBR也未随取卵周期数显著增加。然而,第一个周期(第1周期,20.3%)的每个取卵周期LBR显著高于第二个周期(第2周期,9.2%)和第三个周期(第3周期,4.4%)(P<0.01)。并且94.8%(73/77)的活产发生在前两个周期。在44至45岁及45岁以上的患者中,POR组和NOR组之间每个取卵周期及每位患者的CLBR均无显著差异。
仅在40至43岁且无卵巢反应不良的患者中发现相对较高的累积活产率。这些发现可能提供一些信息,即根据卵巢反应对高龄女性进行进一步亚分类可能有助于临床医生和患者在不孕治疗决策中取得平衡。