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目的女性年龄对体外受精/卵胞浆内单精子显微注射-胚胎移植(IVF/ICSI-ET)助孕结局的影响,旨在为高龄女性推荐较合理的助孕策略。方法回顾性分析2014年4月至2016年9月在济宁市第一人民医院生殖医学科接受IVF/ICSIET助孕治疗的临床资料,按照女性年龄的不同分为4个组,≤37岁组、38-40岁组、41-43岁组、≥44岁组,其中新鲜胚胎移植周期数586,冻胚复苏移植周期数430。结果 (1)新鲜胚胎移植周期中,≤37岁组、38-40岁组、41-43岁组、≥44岁组的临床妊娠率分别为50.43%、35.00%、18.92%、10.34%;流产率分别为15.52%、23.81%、42.86%、66.67%。(2)冻胚复苏移植周期中,≤37岁组、38-40岁组、41-43岁组、≥44岁组的临床妊娠率分别为51.86%、32.26%、18.52%、8.69%;流产率分别为11.05%、20.00%、40.00%、50.00%。上述各组指标比较,差异有统计学意义(P<0.05)。结论女性超过37岁以后,随年龄增长,接受IVF/ICSI-ET助孕治疗的临床妊娠率明显下降,自然流产率明显升高,44岁以后尤为明显。IVF助孕治疗是否应设定年龄上限有待进一步研究。
The purpose of female age on in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF / ICSI-ET) pregnancy outcomes, aims to recommend a more reasonable for older women assisted pregnancy strategy. Methods The clinical data of IVF / ICSIET assisted pregnancy in reproductive medicine department of Jining First People ’s Hospital from April 2014 to September 2016 were retrospectively analyzed. According to the different ages of women, they were divided into 4 groups, ≤37 years old group, 38-40 years old group, 41-43 years old group, ≥44 years old group, of which fresh embryo transfer cycle number 586, frozen embryo transfer cycle number 430. Results (1) In the fresh embryo transfer cycle, the clinical pregnancy rates were 50.43%, 35.00%, 18.92% and 10.34% respectively in the groups of ≤37 years old, 38-40 years old, 41-43 years old and ≥44 years old. The abortion Rates were 15.52%, 23.81%, 42.86%, 66.67% respectively. (2) The clinical pregnancy rates of the groups of ≤37 years old, 38-40 years old, 41-43 years old and ≥44 years old were 51.86%, 32.26%, 18.52%, 8.69% respectively in the cycle of frozen embryo resuscitation; Rates were 11.05%, 20.00%, 40.00%, 50.00% respectively. The above indicators of each group, the difference was statistically significant (P <0.05). Conclusions After the age of 37, the clinical pregnancy rate of IVF / ICSI-ET assisted pregnancy decreased significantly with the increase of age. The rate of spontaneous abortion increased significantly after 44 years of age. IVF pregnancy treatment should be set whether the upper limit for further study.