Paulson R J, Thornton M H, Francis M M, Salvador H S
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, USA.
Fertil Steril. 1997 May;67(5):949-51. doi: 10.1016/s0015-0282(97)81413-6.
To report the occurrence of an unusual case of successful pregnancy achieved by oocyte donation in a woman > 60 years of age.
Case report.
University-based assisted reproductive technology program.
PATIENT(S): Sixty-three-year old nulligravida, married for 16 years to her 60-year-old husband. Throughout her infertility treatment, the patient was believed to be 10 years younger, as she claimed. She revealed her true age of 63 only upon being referred for obstetric care at 13 weeks of gestational age.
INTERVENTION(S): Oocyte donation, IVF, embryo cryopreservation, and ET.
MAIN OUTCOME MEASURE(S): Attainment of pregnancy and subsequent delivery.
RESULT(S): The patient underwent two cycles of oocyte donation. During the second attempt, the fresh transfer resulted in a clinical miscarriage at approximately 8 weeks of gestational age. A subsequent transfer of three frozen-thawed embryos resulted in an ongoing singleton gestation. The pregnancy was complicated by gestational diabetes (controlled by diet) and mild pregnancy-induced hypertension. Delivery by cesarean section at 38 weeks of gestational age resulted in the birth of a healthy female infant weighing 2,844 g with Apgar scores of 9 and 9.
CONCLUSION(S): This case demonstrates that the uterus is capable of supporting nidation and subsequent gestation for many years beyond natural menopause. It shows that other aspects of human physiology are capable of adapting to the stresses and changes of pregnancy sufficiently well to achieve a normal birth at the age of 63 years. This case also exemplifies the difficulty in attempting to regulate the age of recipients in oocyte donation. As in other aspects of human life, when age limits are applied to the provision of certain services, human beings whose age falls outside of these limits become motivated to deceive the providers of those services to avail themselves of the services.
报告一例60岁以上女性通过卵母细胞捐赠成功妊娠的罕见病例。
病例报告。
大学附属辅助生殖技术项目。
一名63岁未孕女性，与60岁丈夫结婚16年。在整个不孕治疗过程中，患者自称比实际年龄小10岁。直到孕13周转诊至产科护理时，她才透露自己的真实年龄为63岁。
卵母细胞捐赠、体外受精、胚胎冷冻保存及胚胎移植。
妊娠的实现及随后的分娩。
患者接受了两个周期的卵母细胞捐赠。在第二次尝试中，新鲜胚胎移植导致孕约8周时临床流产。随后移植三个解冻胚胎后，实现了单胎持续妊娠。妊娠合并妊娠期糖尿病（通过饮食控制）和轻度妊娠高血压。孕38周行剖宫产分娩出一名健康女婴，体重2844g，阿氏评分分别为9分和9分。
该病例表明，子宫在自然绝经多年后仍有能力支持着床及随后的妊娠。这表明人类生理的其他方面能够充分适应妊娠的压力和变化，从而在63岁时实现正常分娩。该病例还例证了在卵母细胞捐赠中试图规范受者年龄的困难。正如在人类生活的其他方面一样，当对提供某些服务设定年龄限制时，年龄超出这些限制的人就会有动机欺骗服务提供者以获得这些服务。
