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目的 评估女性年龄对供精人工授精(AID)累积活产率的影响。方法 回顾性分析2017年1月1日至2021年12月31日于西北妇女儿童医院生殖中心行AID治疗的1 429例患者(3 354个AID治疗周期)的临床资料，并按照女性年龄分为4组：<35岁组(1 291例),35～<38岁组(92例),38～<40岁组(29例)和≥40岁组(17例),比较各组间的保守累积活产率和乐观累积活产率。结果 不同年龄组女性AID治疗后的妊娠结局比较显示，<35岁组的临床妊娠率、活产率最高，妊娠丢失率最低；≥40岁组的临床妊娠率、活产率最低，妊娠丢失率最高，且各组间差异均具有统计学意义(P<0.05)。各年龄组的保守累积活产率分别为：<35岁组61.50%,35～<38岁组48.91%,38～<40岁组24.14%,≥40岁组11.76%。随着女性年龄的增加，AID治疗的保守及乐观累积活产率均显著降低(P<0.001)。年龄≥40岁女性，第1周期AID治疗的活产率仅为5.88%,两个治疗周期后的累积活产率为11.76%,且之后再增加AID周期累积活产率并无明显提高。结论 AID治疗周期的累积活产率随着女性年龄增长而下降，≥40岁女性的累积活产率下降更明显，且多周期AID治疗对这类人群无明显益处。
Abstract：Objective:To evaluate the impact of female age on the cumulative live birth rates of artificial insemination with donor sperm(AID) cycles.Methods:The clinical data of 1 429 patients(3 354 AID cycles) who underwent AID at the Reproductive Medicine Center of Northwest Women's and Children's Hospital from Jan. 2017 to Dec. 2021 were retrospectively analyzed. According to female age, they were divided into four groups: <35 years old group(n=1 291),35-<38 years old group(n=92),38-<40 years old group(n=29),and ≥40 years old group(n=17). The basic data, pregnancy outcomes, conservative cumulative live birth rate, and optimistic cumulative live birth rate of patients in each group.Results:The comparison of pregnancy outcomes among women of different age groups after AID treatment shows that the <35 years old group had the highest clinical pregnancy rate & live birth rate, and the lowest pregnancy loss rate. The clinical pregnancy rate and live birth rate were the lowest in the ≥40 years old group, while the pregnancy loss rate was the highest, and the differences between different age groups were statistically significant(P<0.05). The conservative cumulative live birth rate was 61.50% in <35 years old group, 48.91% in 35-<38 years old group, 24.14% in 38-<40 years old group and 11.76% in ≥40 years old group, respectively. The conservative and optimistic cumulative live birth rate of AID treatment significantly decrease with the increase of women age(P<0.001). For women aged ≥40 years old, the live birth rate of the first AID treatment cycle was only 5.88%,and the cumulative live birth rate after two treatment cycles was 11.76%. Furthermore, there was no significant increase in the cumulative live birth rate after increasing the AID cycle.Conclusions:The cumulative live birth rate of AID treatment cycles decreases with the increase of women age, and the cumulative live birth rate of women aged ≥40 years old decreases more significantly, while multicycle AID treatment has no significant benefits for this population.
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基本信息:
中图分类号:R714.8
引用信息:
[1]徐洁,张洲,王辉,等.女性年龄对供精人工授精累积活产率的影响[J].生殖医学杂志,2023,32(11):1668-1673.
基金信息:
陕西省卫生健康科研基金项目(2022A022)
2023-11-15
2023-11-15