Female subfertility
Female subfertility
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DOI：
10.1038/s41572-018-0058-8
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发表时间：
2019-01-24
影响因子：
81.5
通讯作者：
Boivin, Jacky
中科院分区：
文献类型：
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作者：
Farquhar, Cynthia M.;Bhattacharya, Siladitya;Boivin, Jacky
生育力低下很常见，每六对夫妇中就有一对受到影响，其中一半人无法解释他们推迟怀孕的原因。过去50年来，在诊断和治疗生育力低下方面的发展确实令人瞩目。事实上，目前这几代生育能力低下的夫妇比前几代人更幸运，因为他们有更多的机会成为父母。及时获得有效的生育力低下治疗很重要，因为许多夫妇在生育力低下的年龄效应限制成功的可能性之前，机会之窗很窄。辅助生殖可以克服输卵管疾病和精子数量低造成的生育障碍，但在减少年龄增加对卵巢功能的影响方面进展甚微。未来5-10年，低生育率妇女的出生率可能会进一步增加，人们对生活方式因素的认识会提高，目前的辅助生殖技术可能会得到改进，新技术也会得到开发。这些进展将带来关于生殖细胞操作、人工配子、胚胎遗传筛查和胚胎基因编辑等治疗的潜在益处和危害的挑战性问题。我们希望看到低收入国家的生育意识、获得安全和具有成本效益的生育护理的机会大幅提高，并缩小目前获得生育护理的差距。
Subfertility is common and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations, as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ cell manipulation, artificial gametes, genetic screening of embryos and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries and a reduction in the current disparity of access to fertility care.