THE INFLUENCE OF OVARIAN RESPONSE ON GAMETE INTRAFALLOPIAN TRANSFER OUTCOME IN OLDER WOMEN

被引：9

作者：

ALSHAWAF, T

NOLAN, A

GUIRGIS, R

HARPER, J

SANTIS, M

CRAFT, I

机构：

[1] London Fertility and Gynaecology Centre, Cozens House, London WIN 1AF

来源：

HUMAN REPRODUCTION | 1992年 / 7卷 / 08期

关键词：

GAMETE INTRAFALLOPIAN TRANSFER; OLDER AGED WOMEN; OVARIAN RESPONSE; PREGNANCY RATE;

D O I：

10.1093/oxfordjournals.humrep.a137802

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged greater-than-or-equal-to 40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GIFT) cycles in women aged greater-than-or-equal-to 40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum beta-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1-3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4- 10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonadotrophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged greater-than-or-equal-to 40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.

引用

页码：1106 / 1110

页数：5

共 31 条

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