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限制高龄男性使用辅助生殖技术——从北欧角度看利弊。

Limiting access to assisted reproductive technologies for males of advanced age-Pros and cons from a Nordic perspective.

机构信息

Fertility Department Sor, Telemark Hospital Trust, Porsgrunn, Norway.

Center for Fertility and Health, National Institute of Public Health, Oslo, Norway.

出版信息

Acta Obstet Gynecol Scand. 2024 Nov;103(11):2124-2129. doi: 10.1111/aogs.14944. Epub 2024 Aug 14.

DOI:10.1111/aogs.14944
PMID:39140140
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11502453/
Abstract

It is not controversial to state that parental age is increasing in several countries. But how to deal with this increase might be. Some Nordic countries have set an upper age limit for females seeking assisted reproduction in their national legislation, but none have done so for males. There are also recommendations in place that restrict access to publicly funded assisted reproduction for both females and males of advanced age in some Nordic countries. As recent data now show somatic and psychiatric health risks related to advanced paternal age, we ask if the time has come for countries to set an upper age limit for males seeking assisted reproduction like there already is for females, and summarize some of the risks and rewards involved in treating couples with advanced age in fertility clinics.

摘要

可以毫不夸张地说,在一些国家,父母的年龄正在增加。但如何应对这种增长可能是一个问题。一些北欧国家在国家立法中为寻求辅助生殖的女性设定了年龄上限,但没有为男性设定。一些北欧国家也有建议,限制高龄女性和男性获得公共资助的辅助生殖的机会。由于最近的数据显示,与高龄父亲相关的躯体和精神健康风险,我们不禁要问,是否到了为寻求辅助生殖的男性设定年龄上限的时候了,就像已经为女性设定的那样,并总结了在生育诊所中治疗高龄夫妇所涉及的一些风险和回报。

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本文引用的文献

1
Paternal age, risk of congenital anomalies, and birth outcomes: a population-based cohort study.父亲年龄、先天畸形风险和生育结局:基于人群的队列研究。
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Impact of paternal age on assisted reproductive technology outcomes and offspring health: a systematic review.父亲年龄对辅助生殖技术结局和后代健康的影响:系统评价。
Andrology. 2023 Sep;11(6):973-986. doi: 10.1111/andr.13385. Epub 2023 Jan 22.
4
Fertility in the aging male: a systematic review.男性生育力随年龄增长而下降:系统综述。
Fertil Steril. 2022 Dec;118(6):1022-1034. doi: 10.1016/j.fertnstert.2022.10.035.
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The risky business of advanced paternal age: neurodevelopmental and psychosocial implications for children of older fathers.高龄父亲的风险业务:对老年父亲的孩子的神经发育和社会心理影响。
Fertil Steril. 2022 Dec;118(6):1013-1021. doi: 10.1016/j.fertnstert.2022.10.029. Epub 2022 Nov 5.
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Is paternal age associated with transfer day, developmental stage, morphology, and initial hCG-rise of the competent blastocyst leading to live birth? A multicenter cohort study.父亲年龄与囊胚的移植日、发育阶段、形态和初始 hCG 升高是否有关,从而导致活产?一项多中心队列研究。
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Advancing paternal age does not negatively impact fresh embryo transfer cycle outcomes.高龄父亲并不会对新鲜胚胎移植周期的结局产生负面影响。
Reprod Biomed Online. 2022 Oct;45(4):737-744. doi: 10.1016/j.rbmo.2022.04.014. Epub 2022 Apr 29.
8
Does advanced paternal age affect outcomes following assisted reproductive technology? A systematic review and meta-analysis.高龄父亲年龄是否会影响辅助生殖技术后的结局?系统评价和荟萃分析。
Reprod Biomed Online. 2022 Aug;45(2):283-331. doi: 10.1016/j.rbmo.2022.03.031. Epub 2022 Apr 10.
9
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Acta Obstet Gynecol Scand. 2021 Oct;100(10):1858-1867. doi: 10.1111/aogs.14221. Epub 2021 Aug 17.
10
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I.男性不育的诊断与治疗:AUA/ASRM 指南 第一部分。
Fertil Steril. 2021 Jan;115(1):54-61. doi: 10.1016/j.fertnstert.2020.11.015. Epub 2020 Dec 9.