40岁及以上不孕患者的治疗结局+—+单中心回顾性分析.pdf

该【40岁及以上不孕患者的治疗结局+—+单中心回顾性分析 】是由【小泥巴】上传分享，文档一共【6】页，该文档可以免费在线阅读，需要了解更多关于【40岁及以上不孕患者的治疗结局+—+单中心回顾性分析 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。:..·392·??????2023?3??32??3?DOI:.1004‐?????????????—???????????1,???2,??1*(1.???????К??????К??????????,??????????,??????????????,К?100730;2.????????????,??530000)【??】????≥40??????????,??????????????????。???????2017?1??2019?12??К???????????????????、≥40???????????,?100?,????????,???б?????????????。??????????????????:?????б?%(76/100)、????????б?%(55/100)、??????б?%(45/100)、???θ?б?%(3/100)、?????б?%(2/100)。?????????????????????%(28/100),????%(12/100),????≥43??????????0%,??????????IVF‐ET??б,??????????????(?>)。?????????б,??????????????、????≤3?????б??,?????????(?<)。Logistic??????,??[??=,95%??(,),?=]?????[??=,95%??(,),?=]?????????????;?????、????、??FSH??????????????(?>)。??40??????????????????????,IVF‐ET???????????????,???????????????????????。【???】???;????‐????;????【?????】【?????】A???????????????????????????????????????????????????-??????????????????????????????????121*?????‐????,???????‐????,????????1.???????????????????????????????????????????????,??????????????????????????????????????????????????????????????,?????????????????????????????????,?????????????????????????????????????????????????????????,???????1007302.?????????????????????????????????????????????????????????????,???????530000【????????】?????????:Toinvestigatetheetiologyofinfertilewomen≥40yearsold,andexploretherelatedeaftersurgicaltreatment.???????:Theclinicaldataof100elderlyinfertilewomen≥.???????:Theproportionofinfertilityfactorsofthepatientsincludedwasasfollows:%(76/100),%(55/100),%(45/100),%(3/100),%(2/100).%(28/100),%(12/100).urredamongthepatients≥【????】2022‐10‐15;【????】2023‐01‐06【????】???,?,???????,??,??,??????.(*????):..??????2023?3??32??3?·393·naturalpregnancyandthosewhounderwentIVF‐ET(?>).Comparedwiththepatientswithoutpregnancy,thepatientswithclinicalpregnancyweresignificantlyyounger,andtheproportionofpatientswithinfertility≤3yearswassignificantlyhigher(?<).Logisticregressionanalysisindicatedthatage[??=,95%??(,),?=]andinfertilityduration[??=,95%??(,),?=],theinfertilityfactors,e(?>).???????????:Theoverallpregnancyrateandlivebirthrateofinfertilewomen≥40yearsoldarelower,andtheIVF‐.????????:Infertility;IVF‐ET;es(??????????2023,32(03):392‐397)???????????????????,????????,????????????????????,??????????????,????????????????,?????????。?????????????????????(??≥3cm)?????????,???С????????????????,??????????????,??????????????,???????,???????????????????????。??????.2?”???35????????。???????:?????28~35d????”?????,??????、??、???????,?????????????????,????????????30?,???40????????????????????????,????????????。??40?????????????????。?????,?????????????,???3.?????????????:???????????/????????,?????????????????,????????????????(rAFS/rASRM)?]2]?????????????????????????,Ч????????2017?1??2019?12??????К??????????,???????(EFI)。???????40?????????????,4.????:б???????????????。????????、????、??????、?????????????????????,??????、??FSH??、??????(AMH)ь???????????????????。??;???????????IVF‐ET;????????????????、???。?????=?????????/?????×100%;???=????、????????/??????×100%。?????2017?1??2019?12??К?、????????????????????????100???????????????。??????????。??????????????[?(?25,?75)]??,????:(1)?????≥40?;(2)?????[1]??б??????;?????????????????????????;(3)??????????±???(?珔±?)??,??б??????;????;(4)????????IVF‐ET??;(5)???2??????(%)??,??б???χ??;????????2022?3?,??????。?????э?????Logistic????,????????:(1)??????;(2)?????????????。?<???????????。?/????????????;(3)?????????;(4)???。??????????、??、????????????????1.?????????:?????????Ч?????40??????????100?,:..·394·??????2023?3??32??3?????????,)100/28(%?б??????、???????????б??б?72%(72/100)。?????????б???????????????????????:(1)??????:?76?,??55?????,????????????、???????????,?????????27?,?????14????????,??????????????,????7?,????4?(????2?,???????。??1?,???1?);(2)???????:??551.??????????????б?:???,??1?25?,2?9?,3?10?,4?11?,????????,?????????(?=28)EFI?????。)72=?(?????:?????)3(;?)±(???????,??????45?,?????????????(?9???????????????,????≤3????????2??????????,5??????б????????(?<),???AMH?????,?????????????,????、???????????б??б????2??????????????),?????????(?>)(?2)。?????????:????.2???????,?18????????????????????11?,???????????????(?=12)?????(?=88)。?????、?????,??7?????????,????????、AMH??、???????????б??б????,????????????;(4)???θ???????(?>)。????????3%(3/100)?2%(2/100)(?1)。3.??????:???????????????????????[(?±?),?(?25,?75),?(%)]????(?=59)?IVF‐ET?(?=41)。???????????б???????(?>)(?3)。??(,)?、??????????????wb倐]????(,)??100????????????%w倐/????(,)(28/100),????%(12/100)。?????w倐/????(,)???28????,????13?,??????w倐/??FSH/(U/L)±%(13/28),?????????????2?,w^倐AMH/(ng/ml)(,)??1??21???????,?1??????w倐/????28()?,??????%(2/28);?????????????72()????????????1?。??、????、??FSH??????76()??、????????????。???????55()1.??:??40???????,??????????45()???????,?????????????????θ3()????,??≥43?????????0%佑揶????2()(?1)。佑揶?????????????????б?[(?±?),?(?25,?75),?(%)]??????????????????????≤3?>3?IVF‐ET?????????2840(40,41)20()8()14()14()7()21()V葺Pd唵ゥa梃殮[憫????7241(40,42)*34()*38()*27()45()21()51()V葺Pd唵ゥa梃殮[憫????AMH/???????θ?????????????????????(ng/ml)?????282()13()17()0()22()±%览档db0?J潩è????721()32()38()2()54()±%览档db0?J潩è?:??????б?,*?<。:..??????2023?3??32??3?·395·??????????????б?[(?±?),?(?25,?75),%]????FSH/??????????????????????????θ??(U/L)???Ⅰ‐Ⅱ?Ⅲ‐Ⅳ?IVF‐ET?(,)±±()2()20()7()13()WVdb滗沣靠a创?????(,42)±±()1()35()14()21()WVdb滗靠a创????????????????????????????????????????????IVF‐ET?4120()10()0()32()22()6()6()2()厖揶d5*5*唵殚?J悙憫?????5925()22()2()44()32()21()8()5()厖揶d5*5*唵殚?J悙憫24),??FSH<10U/L?FSH???(?=45)。FSH??????????%(4/24),????%(3/24),??FSH<10U/L????????%(18/45),????%(8/45),????????????б???????(?>)。4.????:??????????????≤3?(?=54)?????>3??(?=46)。????≤3?????????%(20/54),????>3?????????%(8/46),????????б?????????(?<);??????????????????????≤3???????%(8/54),??2.????:??????????????>3???????%(4/46),?????%(14/59),????%(7/59),IVF‐ET?б??????(?>)。???????%(14/41),????%?、?????????Logistic????(5/41),????????????б?????Logistic??????,??[??=,??(?>)。95%??(,)]?????[??=,3.??FSH??:Ч????69?????95%??(,)]???????????????FSH??。????FSH??[3]????(?<),?????????????????:??FSH≥10U/L?FSH???(?=(?4)。???????????Logistic??????????????????(95%??)???(95%??)???(,)*(,)>5*q8哌????(,)*(,)>5*q哌85*q哌8????(,)(,)>5*q8哌???????(,)(,)>5*q8哌???????(,)(,)>5*q8哌???(,)(,)@煙种C怂>5*8哌??????(,)(,)>5*q8哌??????(,)(,)>5*q8哌FSH/(U/L)(,)(,)>5*q8哌AMH/(ng/ml)(,)(,)>5*q8哌?:*?<。:..·396·??????2023?3??32??3??,?????????????,40????????IVF‐ET?????????????????[14]Ч???????2017?1??2019?12???11%。Ч??????,?IVF‐ET????????????≥40???????????????????????????(%vs.??,?????100????,????????%),?????????(?>),???%(28/100),??????%(12/100);?б???????(%%)(?>???????28????,????13?)。????,“??????”???????(%),?????????,???????????????2???????????(%)。????,≥40?????,?ь???????,??????。??????IVF‐ET??,???????,??Ч??????????,%(41/100)?????????????????????。????????IVF‐ET????,?????Ч??????,??≥40?????,??????б,???????????????,??????????????,??≥43??????????б???????(?>),??,??????????????????ET‐IVF??????????ET‐IVF????,??。??Heffner[3]?Б?,?1991??2004???????12%??。??????,IVF‐ET??,????????????40~44????б???≥40??????????,??????????70%,??????????????。????????、?????????????。??????????????????????????????????????,??????,??????????????[4]。FernandezIVF‐ET,?40????????????????[5]???????,833?≥43???????????,??≥40??????????IVF/ICSI????HCG????%,?????。??%。??????????,?ь?????,Ч????,????≥3?????????????????,≥42?????????????????<3???(?<),?????????,??????????44≥????????????????。????ACOG[6‐8][15]?。?????(≥35?)?,?ь????????“40??????????????????????????,????????。??????”???????。????????,????????С?????????????????????、?????????????,??????????????????????????????????,??????,?????????。??,????????????????;?????,???????????????П????????(??60%),?????,???????。??????????[9‐11]。?????Ч??????FSH??10U/L?????,????????,40???????ь????,???????????б???????(?>???????%(13/28)。??,????),????FSH????40??????????,????????、???????????????????????。Ч????????????????,????????????,?24??????AMH??,??????[16]??????,??????????。?????。Carosso?????,40???????????????,??????????IVF‐ET????????%,????????,???????????+???????????,???????????、????????????,35~37?????????????????????????,????????%,41~42????%,????????????42??。??????????%[12];?IVF???,????,40??????????????35????????????????%,???,??????????,?????????43???????????%[13]。????,??????IVF‐ET???????????:..??????2023?3??32??3?·397·?????,????????????????[8]YinH,JiangH,HeR,????????。?????????????advanced‐agewomenmorethan40withorwithoutpoorovarianresponse[J].TaiwanJObstetGynecol,2019,58:????б??ET‐IVF???????,???201‐205.?????????,????????????[9]TouatiSA,:????????????????。??40?spindlecheckpointcontrolinmeiosis[J].Chromosoma,2016,????????,?????????????125:321‐335.???,??????????????????[10]CamaioniA,UcciMA,CampagnoloL,:itisnotjustaboutoocytesandgranulosacells?????????。[J].,2022,39:783‐792.[11]YanF,ZhaoQ,LiY,【????】ovarianaging:areview[J].JOvarianRes,2022,15:100.[1]CarsonSA,[12]DoveyS,SneeringerRM,:Areview[J].JAMA,2021,326:65‐:analysisofmorethan4100cycles[2]AdamsonGD,:the[J].FertilSteril,2008,90:2281‐,validatedendometriosisstagingsystem[J].FertilSteril,[13]SunderamS,KissinDM,ZhangY,,94:1609‐‐unitedstates,2018[J].[3]‐‐howoldistooold?MMWRSurveillSumm,2022,71:1‐19.[J].NEnglJMed,2004,351:1927‐1929.[14]HsuLT,ChinTH,HuangSY,[4]?[J].FertilSteril,einadvance‐agedwomen[J].TaiwanJ2022,117:682‐,2021,60:1047‐1053.[5]FernandezAM,DrakopoulosP,RosettiJ,[15]AmericanCollegeofObstetriciansandGynecologistswomenaged43yearsandolder:a20‐yearexperience[J/OL].,2021,42:768‐‐mitteeopinionNo.[6]LiuM,ZhaoX,PengY,[J].FertilSteril,2014,101:633‐