母亲年龄对接受体外受精和胚胎移植（IVF-ET）的女性临床结局的影响。

Effect of maternal age on clinical outcome in women undergoing in vitro fertilization and embryo transfer (IVF-ET).

作者信息

Preutthipan S, Amso N, Curtis P, Shaw R W

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 1996 Jun;79(6):347-52.

PMID:8855607

Abstract

The purpose of this study was to assess the effect of age of IVF success in women undergoing in vitro fertilization and embryo transfer by comparing IVF outcome in two groups of patients: group 1-age < or = 35 years old and group 2-age > 35 years old. This retrospective study covered a one year period between January 1991-December 1991 and included 230 patients with 634 treatment cycles. The patients' mean age was 32 +/- 1.9 (range 20-38 years old). Inclusion criteria for treatment of patients with IVF-ET included patients with tubal disease and non-tubal disease who have failed conventional treatments. The majority of patients had infertility from tubal damage, unexplained infertility, and male infertility. This study showed that all pregnancy rates, ongoing pregnancy rates and implantation rates were found to be higher in the < or = 35 year old group. The pregnancy rate per ET, ongoing pregnancy rate and implantation rate were found to be 35.17, 27.58, 16.53 per cent respectively; while in the > 35 year old group, the pregnancy rate per ET, ongoing pregnancy rate, implantation rate were found to be only 17.93, 11.03, 8.07 per cent respectively. The miscarriage rate tended to be higher in the > 35 year old group (34.62%) compared to 15.69 per cent found in < or = 35 year old group. Multiple pregnancy rate and ectopic pregnancy rate were found to be 17.65 and 5.89 per cent respectively for the < or = 35 year old group but only 7.69, 3.85 per cent respectively for the > 35 year old group. From the statistical analysis comparing the outcome of pregnancy in these two groups, the pregnancy rate per ET, implantation rate, ongoing pregnancy rate and miscarriage rate were found to have statistical difference with P < 0.05. However, multiple pregnancy rate and ectopic pregnancy rate did not show any statistical significance in these two groups (P > 0.05). In conclusion, the results of this study indicated that maternal age especially when greater than 35 years old adversely affects clinical pregnancy and the spontaneous abortion rate.

摘要

本研究的目的是通过比较两组患者的体外受精结果，评估年龄对接受体外受精和胚胎移植女性的体外受精成功率的影响：第1组年龄≤35岁，第2组年龄＞35岁。这项回顾性研究涵盖了1991年1月至1991年12月的一年时间，包括230例患者和634个治疗周期。患者的平均年龄为32±1.9岁（范围20 - 38岁）。接受体外受精 - 胚胎移植治疗的患者纳入标准包括输卵管疾病患者和非输卵管疾病患者，他们均常规治疗失败。大多数患者因输卵管损伤、不明原因不孕和男性不育导致不孕。本研究表明，≤35岁组的所有妊娠率、持续妊娠率和着床率均较高。每个胚胎移植周期的妊娠率、持续妊娠率和着床率分别为35.17%、27.58%、16.53%；而在＞35岁组中，每个胚胎移植周期的妊娠率、持续妊娠率、着床率分别仅为17.93%、11.03%、8.07%。＞35岁组的流产率（34.62%）往往高于≤35岁组（15.69%）。≤35岁组的多胎妊娠率和异位妊娠率分别为17.65%和5.89%，而＞35岁组分别仅为7.69%、3.85%。通过对这两组妊娠结局的统计分析，发现每个胚胎移植周期的妊娠率、着床率、持续妊娠率和流产率存在统计学差异，P＜0.05。然而，这两组的多胎妊娠率和异位妊娠率未显示出任何统计学意义（P＞0.05）。总之，本研究结果表明，母亲年龄尤其是大于35岁时会对临床妊娠和自然流产率产生不利影响。