Chang Hui, Li Jian, Wu Qi, Fu Xin, Zhu Mengyi, Ge Hang, Shi Baichao, Shao Xiaoguang, Han Yanhua
Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China.
Heilongjiang University of Chinese Medicine, Harbin 150040, China.
Evid Based Complement Alternat Med. 2022 Aug 22;2022:2977636. doi: 10.1155/2022/2977636. eCollection 2022.
Our aim was to investigate the effect of age on the outcome of IVF-ET and ICSI in infertile PCOS patients under the guidance of Tiangui theory in traditional Chinese medicine.
This was a retrospective analysis of 532 infertile women with PCOS and 1,392 women with infertility due to tubal factors as the controls. All of the participants were divided into different age groups-aged 20-28 years, 29-35 years, and ≥36 years-according to the stages of female reproductive development in Tiangui theory as described in the Canon of Internal Medicine-Treatise of Ancient Natural Truth. We explored the effect of age on controlled ovarian hyperstimulation (including the initial dosage and duration of Gn and the estradiol level on the day of human chorionic gonadotropin administration); the numbers of retrieved oocytes, 2PN zygotes, and embryos; and the rates of fertilization, clinical pregnancy, abortion, live birth, and OHSS incidence.
Compared to controls, the maximum follicular diameter and the numbers of follicles with d ≥ 20 mm, retrieved oocytes, and 2PN zygotes were greater in the PCOS group with age >28 years ( < 0.05). The abortion rate of PCOS patients with age ≤28 years was higher than that of the controls. All PCOS groups and the control group showed reduced numbers of retrieved oocytes and live births with age. The difference in age was not significant in the PCOS groups but was significant in the control group ( < 0.05), and the trend in the PCOS groups was more gradual.
The fertility of all subjects decreased with age, but PCOS patients decreased more slowly than in controls at the same age, which verified the applicability of the guiding principles of Tiangui theory in the clinic.
本研究旨在探讨年龄对中医天癸理论指导下的多囊卵巢综合征（PCOS）不孕患者体外受精-胚胎移植（IVF-ET）及卵胞浆内单精子注射（ICSI）结局的影响。
本研究为回顾性分析，以532例PCOS不孕女性为研究对象，1392例输卵管因素不孕女性作为对照。根据《黄帝内经·上古天真论》中所述天癸理论，将所有参与者按照女性生殖发育阶段分为不同年龄组：20 - 28岁、29 - 35岁、≥36岁。我们探讨了年龄对控制性卵巢刺激的影响（包括促性腺激素（Gn）的初始剂量和使用时间以及人绒毛膜促性腺激素注射日的雌二醇水平）；获取的卵母细胞、双原核（2PN）受精卵和胚胎数量；以及受精率、临床妊娠率、流产率、活产率和卵巢过度刺激综合征（OHSS）发生率。
与对照组相比，年龄>28岁的PCOS组最大卵泡直径、直径≥20 mm的卵泡数量、获取的卵母细胞和2PN受精卵数量更多（P<0.05）。年龄≤28岁的PCOS患者流产率高于对照组。所有PCOS组和对照组获取的卵母细胞数量和活产率均随年龄增长而降低。年龄差异在PCOS组中不显著，但在对照组中显著（P<0.05），且PCOS组的变化趋势更为平缓。
所有研究对象的生育能力均随年龄下降，但PCOS患者在同一年龄段下降速度比对照组慢，这验证了天癸理论指导原则在临床中的适用性。
