The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA.
Foundation for Reproductive Medicine, New York, NY, USA.
J Assist Reprod Genet. 2020 Jul;37(7):1583-1588. doi: 10.1007/s10815-020-01847-x. Epub 2020 Jun 6.
Based on national registry reports, after age 42, the number of IVF cycles utilizing autologous oocytes is very small; after age 43, autologous oocyte use in US IVF cycles is almost non-existent. We here argue that the in vitro fertilization (IVF) field has created a self-fulfilling prophecy by basically abandoning the utilization of autologous oocytes after ages 42-43 years. This not only resulted in almost no IVF cycles with autologous oocytes being performed but also in abandonment of research that could lead to improvements in IVF outcomes in older women when using autologous oocytes. As a consequence, IVF has largely stagnated in this area. We further argue that third-party oocyte donation in clinical IVF should be considered a treatment failure, as it requires patients to choose a second rather than a first-choice treatment. Such a redesignation of third-party egg donation would not only be appropriate but could lead to necessary changes in physician attitudes, considering that women almost exclusively prefer to conceive with their autologous oocytes.
基于国家注册报告，42 岁以后，使用自体卵的 IVF 周期数量非常少；43 岁以后，美国 IVF 周期中几乎不再使用自体卵。我们认为，体外受精（IVF）领域通过基本放弃 42-43 岁以后使用自体卵，创造了一个自我实现的预言。这不仅导致几乎没有进行自体卵 IVF 周期，而且也放弃了可能导致使用自体卵的老年女性 IVF 结局改善的研究。因此，IVF 在这一领域基本停滞不前。我们进一步认为，临床 IVF 中的第三方卵子捐赠应被视为治疗失败，因为它要求患者选择第二种而不是首选治疗。这种对第三方卵子捐赠的重新指定不仅是合适的，而且可以导致医生态度的必要改变，因为女性几乎完全更喜欢使用自己的自体卵受孕。
