The paradox of declining fertility but increasing twinning rates with advancing maternal age
The paradox of declining fertility but increasing twinning rates with advancing maternal age
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DOI：
10.1093/humrep/del009
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发表时间：
2006-06-01
影响因子：
6.1
通讯作者：
Lambalk, C. B.
中科院分区：
文献类型：
--
作者：
Beemsterboer, S. N.;Homburg, R.;Lambalk, C. B.
背景技术背景：女性年龄的增加与生育潜力下降有关，这是由于卵母细胞的数量和质量下降，但也与异卵双胞胎率的明显增加有关，这种现象从未得到解释。方法：对507例妇女959个自然排卵周期的卵泡发育进行分析。研究结果：105例患者的平均年龄（36.1岁vs 34.6岁）和平均基础FSH浓度（10.3 IU/I vs 7.7 IU/I）均显著高于单卵泡发育者（P < 0.01）。多卵泡发育的患病率随着年龄的增长而增加。结论：双卵双生子必须与> 1个大卵泡的发育有关，我们发现这在老年妇女中更常见。据推测，垂体释放FSH对即将发生的卵巢衰竭引起的负反馈减少的反应经常“超调”，导致多个卵泡发育。如果有两个优质卵母细胞，可能会导致双胎妊娠。
BACKGROUND: Advancing female age is associated with declining fertility potential due to decreasing numbers and quality of oocytes but also with a distinct increase in dizygotic twinning rates, a phenomenon that has never been explained. METHOD: An analysis of follicle development was made in 959 spontaneous ovulatory cycles of 507 women. RESULTS: Multiple ovarian follicular development (> 1 follicle > 14 mm) and, by implication, multiple rather than single ovulations occurred in 105 women whose mean age (36.1 versus 34.6 years) and mean basal FSH concentrations (10.3 versus 7.7 IU/I) were significantly greater than those with monofollicular development (P < 0.01). The prevalence of multifollicular development increased with age. CONCLUSIONS: Dizygotic twinning must be associated with the development of > 1 large follicle, which we found to be a significantly more frequent occurrence in older women. It is hypothesized that the response of pituitary release of FSH to the decreased negative feedback induced by impending ovarian failure often 'overshoots', causing multiple follicular development. In the presence of two good-quality oocytes, a twin pregnancy may result.