Fitzgerald C T, Seif M W, Killick S R, Elstein M
Department of Obstetrics and Gynaecology, University Hospital of South Manchester, West Didsbury, UK.
Br J Obstet Gynaecol. 1994 Mar;101(3):229-33. doi: 10.1111/j.1471-0528.1994.tb13115.x.
To investigate the effect of age on the control of the reproductive cycle in regularly menstruating women.
In this prospective study all women were seen regularly during both the follicular and luteal phases. Ultrasound scanning was used to confirm ovulation and measurements were taken to assess follicular development and endometrial thickness. Serum gonadotrophin levels on day 4 of the cycle, the maximum periovulatory oestradiol and progesterone on the seventh day after ovulation were measured and compared in different age groups.
SUBJECTS & SETTING: Fifty-six healthy, regularly menstruating women were recruited from volunteers amongst staff of the University Hospital of South Manchester.
Ovulation occurred later in the cycle for older women, with mean follicular phase length increasing from 13.9 days (in group 21-25 years) to 15.9 days (in group 37-45 years (P < 0.05). The mean of the maximum follicular diameter prior to rupture was significantly smaller in the older women: 16.7 mm in the 37 to 45 years old group compared with 19.6 mm, 21.6 mm and 21.3 mm in the 21 to 25, 26 to 31 and 32 to 36 years old age groups, respectively (P < 0.001). The maximum thickness of the endometrium in the luteal phase was greatest for older women: 15.9 mm in the age group 37 to 45 years compared with 12.1 mm in the age group 21 to 25 years (P < 0.001). Serum gonadotrophin concentrations during menses were higher with increased age; mean follicle stimulating hormone was 4.8 iu/l in the age group 21 to 25 years, and 8.5 iu/l in the age group 37 to 45 years (P < 0.001). Mean luteinising hormone was 4.5 iu/l in age group 21 to 25 years and 7.21 iu/l in age group 37 to 45 years (P < 0.001). Mean ovarian steroid concentrations were no different.
These data illustrate significant age related differences in the pituitary-ovarian axis and endometrial thickness. This has implications for the management of older women in assisted reproduction and fertility control programmes.
研究年龄对月经周期规律的女性生殖周期调控的影响。
在这项前瞻性研究中，对所有女性在卵泡期和黄体期均进行定期观察。采用超声扫描确认排卵情况，并进行测量以评估卵泡发育和子宫内膜厚度。测定并比较不同年龄组在月经周期第4天的血清促性腺激素水平、排卵后第7天的最高排卵期雌二醇和孕酮水平。
从南曼彻斯特大学医院工作人员中的志愿者里招募了56名健康、月经周期规律的女性。
年龄较大的女性排卵发生在月经周期较晚的时候，平均卵泡期长度从21 - 25岁组的13.9天增加到37 - 45岁组的15.9天（P < 0.05）。年龄较大的女性卵泡破裂前的最大卵泡直径平均值显著较小：37至45岁组为16.7毫米，而21至25岁、26至31岁和32至36岁年龄组分别为19.6毫米、21.6毫米和21.3毫米（P < 0.001）。黄体期子宫内膜的最大厚度在年龄较大的女性中最厚：37至45岁年龄组为15.9毫米，而21至25岁年龄组为12.1毫米（P < 0.001）。月经期间血清促性腺激素浓度随年龄增长而升高；21至25岁年龄组的平均促卵泡激素为4.8 iu/l，37至45岁年龄组为8.5 iu/l（P < 0.001）。21至25岁年龄组的平均促黄体生成素为4.5 iu/l，37至45岁年龄组为7.21 iu/l（P < 0.001）。平均卵巢类固醇浓度无差异。
这些数据表明垂体 - 卵巢轴和子宫内膜厚度存在显著的年龄相关差异。这对辅助生殖和生育控制项目中年龄较大女性的管理具有启示意义。
