EFFECT OF AGING ON THE FEMALE REPRODUCTIVE-SYSTEM - EVIDENCE FOR A ROLE OF UTERINE SENESCENCE IN THE DECLINE IN FEMALE FECUNDITY
EFFECT OF AGING ON THE FEMALE REPRODUCTIVE-SYSTEM - EVIDENCE FOR A ROLE OF UTERINE SENESCENCE IN THE DECLINE IN FEMALE FECUNDITY
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DOI：
10.1016/s0015-0282(16)57797-8
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发表时间：
1995-09-01
影响因子：
6.7
通讯作者：
PELLICER, A
中科院分区：
文献类型：
--
作者：
CANO, F;SIMON, C;PELLICER, A
目的：以活体捐献卵子为模型，研究年龄对妇女生殖功能的影响。地点：供卵和体外受精研究所的卵子捐献和体外受精项目。患者：76名接受90个周期卵子捐献的妇女，36名接受体外受精的供者，9名生育妇女。设计：前瞻性纵向研究：[1]受者接受人工周期，以证明子宫内膜对外源性类固醇激素有足够的反应；[2]来自同一批卵泡的卵子被随机分配到40岁以下和40岁以上的受者；主要观察指标：两组受者的子宫内膜组织学、受精率、胚胎质量、妊娠率、着床率和流产率。结果：尽管P对子宫内膜有适当的作用，移植的胚胎数量和质量相似，但40岁妇女的种植率相似，但流产率显著高于正常妊娠妇女。胎盘分泌E(2)和P的时间早于40岁组。结论：年龄增加了卵子植入完成后的妊娠损失。这伴随着类固醇合成的迟缓，表明负责子宫内胎盘形成和功能的机制(S)受年龄的影响。因此，子宫老化也是影响高龄女性生殖性能差的一个因素。
Objective: To determine the effects of age on reproductive performance of women using oocyte donation as an in vivo model.Setting: Oocyte donation and IVF programs at the Institute Valenciano de Infertilidad.Patients: Seventy-six women undergoing 90 cycles of ovum donation, who were recipients of 36 donors undergoing IVF, and 9 fertile women.Design: Prospective longitudinal study: [1] recipients underwent an artificial cycle to demonstrate adequate response of the endometrium to exogenous steroids; [2] oocytes from the same cohort of follicles were distributed randomly into recipients younger and older than 40 years; and [3] pregnancies were followed during the first trimester.Main Outcome Measures: Endometrial histology, fertilization, embryo quality, pregnancy, implantation, and abortion rates in both groups of recipients. Serum E(2), P and beta-hCG levels during initial pregnancy.Results: Similar implantation rates but significantly higher abortion rates were detected in women > 40 years despite an appropriate action of P on the endometrium and the transfer of embryos in similar number and quality. The secretion of E(2) and P by the placenta started earlier in pregnancies included in the group < 40 years.Conclusions: Age increases pregnancy losses in ovum donation patients after implantation is completed. This is accompanied by a retardation of steroid synthesis and suggests that the mechanism(s) responsible for placenta formation and functioning in the uterus is affected by age. Thus, uterine aging also is a factor influencing the poor reproductive performance of women with advancing age.