Cano F, Simón C, Remohí J, Pellicer A
Instituto Valenciano de Infertilidad, Valencia University School of Medicine, Spain.
Fertil Steril. 1995 Sep;64(3):584-9. doi: 10.1016/s0015-0282(16)57797-8.
To determine the effects of age on reproductive performance of women using oocyte donation as an in vivo model.
Oocyte donation and IVF programs at the Instituto Valenciano de Infertilidad.
Seventy-six women undergoing 90 cycles of ovum donation, who were recipients of 36 donors undergoing IVF, and 9 fertile women.
Prospective longitudinal study: [1] recipients underwent an artificial cycle to demonstrate adequate response of the endometrium to exogenous steroids; [2] oocytes from the same cohort of follicles were distributed randomly into recipients younger and older than 40 years; and [3] pregnancies were followed during the first trimester.
Endometrial histology, fertilization, embryo quality, pregnancy, implantation, and abortion rates in both groups of recipients. Serum E2, P and beta-hCG levels during initial pregnancy.
Similar implantation rates but significantly higher abortion rates were detected in women > 40 years despite an appropriate action of P on the endometrium and the transfer of embryos in similar number and quality. The secretion of E2 and P by the placenta started earlier in pregnancies included in the group < 40 years.
Age increases pregnancy losses in ovum donation patients after implantation is completed. This is accompanied by a retardation of steroid synthesis and suggests that the mechanism(s) responsible for placenta formation and functioning in the uterus is affected by age. Thus, uterine aging also is a factor influencing the poor reproductive performance of women with advancing age.
以卵母细胞捐赠作为体内模型，确定年龄对女性生殖性能的影响。
瓦伦西亚不育症研究所的卵母细胞捐赠和体外受精项目。
76名接受90个周期卵子捐赠的女性，她们是36名接受体外受精的捐赠者的受者，以及9名有生育能力的女性。
前瞻性纵向研究：[1]受者接受人工周期以证明子宫内膜对外源性类固醇有足够反应；[2]将来自同一卵泡群的卵母细胞随机分配给年龄小于40岁和大于40岁的受者；[3]在孕早期跟踪妊娠情况。
两组受者的子宫内膜组织学、受精、胚胎质量、妊娠、着床和流产率。初次妊娠期间的血清E2、P和β-hCG水平。
尽管P对子宫内膜有适当作用且移植的胚胎数量和质量相似，但在年龄大于40岁的女性中检测到着床率相似但流产率显著更高。在年龄小于40岁组的妊娠中，胎盘分泌E2和P开始得更早。
年龄增加了卵子捐赠患者着床完成后的妊娠丢失。这伴随着类固醇合成的延迟，并表明子宫中负责胎盘形成和功能的机制受年龄影响。因此，子宫衰老也是影响年龄增长女性生殖性能不佳的一个因素。
