Poor ovarian response as a predictor for live birth in older women undergoing IVF
Poor ovarian response as a predictor for live birth in older women undergoing IVF
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DOI：
10.1016/j.rbmo.2018.01.008
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发表时间：
2018-04-01
影响因子：
4
通讯作者：
Buckett, William
中科院分区：
文献类型：
--
作者：
Cohen, Yoni;Tannus, Samer;Buckett, William
高龄妇女对生育治疗提出了重大挑战。本研究旨在根据博洛尼亚标准评估卵巢不良反应（POR）是否为40岁以上妇女活产的重要预测指标。随后的试管婴儿周期的结果也进行了研究。回顾性分析1212名妇女1870次新鲜试管婴儿周期的结果。收集3个以上卵母细胞的良好应答者每个周期的活产率是收集较少卵母细胞的妇女的3.3倍（11.61%比3.54%,P < 0.001）。卵巢反应由收集的卵母细胞定义，而不是由卵泡数量定义，与活产独立相关（优势比2.0；95%可信区间1.18 ~ 3.54;P = 0.009）。在随后的IVF周期中，POR的发生率仅为55%。与至少有一个良好反应的妇女相比，持续性POR的活产率没有差异。老年妇女第一次体外受精周期单次POR对后续周期的预后预测价值有限。40-43岁女性的POR，由取出的卵母细胞数量定义，是体外受精活产的预测指标。(c) 2018生殖保健有限公司Elsevier Ltd.出版。版权所有。
Women of advanced age present a major challenge for fertility treatments. This study was designed to assess whether poor ovarian response (POR) according to the Bologna criteria is a significant predictor for live birth in women over 40. The outcomes of subsequent IVF cycles were also studied. The results of 1870 fresh IVF cycles in 1212 women were retrospectively analysed. The live birth per cycle was 3.3 times higher (11.61% versus 3.54%, P < 0.001) in good responders with more than three oocytes collected compared with women with less. Ovarian response defined by oocytes collected, but not by the number of follicles, was independently associated with live birth (odds ratio, 2.0; 95% confidence interval, 1.18 to 3.54; P = 0.009). The occurrence of POR in subsequent IVF cycles was only 55%. No differences in live births were found in persistent POR compared with women with at least one good response. A single episode of POR in a first IVF cycle in older women has a limited predictive value for the outcomes of subsequent cycles. POR in women aged 40-43 years, defined by the number of oocytes retrieved, is a predictor for live birth in IVF. (c) 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.