What is the best treatment option for infertile women aged 40 and over?

被引:27
作者
Armstrong, Sarah [1 ]
Akande, Valentine [2 ,3 ]
机构
[1] St Michaels Hosp, Bristol, Avon, England
[2] Southmead Hosp, BCRM, Bristol, Avon, England
[3] Univ Bristol, Bristol, Avon, England
关键词
Fertility; Infertility; Advanced maternal age; IVF; IUI; Diminished ovarian reserve; ART; ASSISTED REPRODUCTIVE TECHNOLOGY; ANTI-MULLERIAN HORMONE; IN-VITRO FERTILIZATION; INTRAUTERINE INSEMINATION; OVARIAN RESERVE; PREGNANCY; DECLINE; CYCLES; BIRTH; TESTS;
D O I
10.1007/s10815-013-9980-6
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
To summarise the causes of decreased fecundity with age and review chronological vs biological ovarian ageing. To explore the clinician's means of assessing a woman's ovarian reserve. To review the recent literature on the effectiveness of different assisted reproductive technology (ART) techniques for women aged 40 and over and offer a single best treatment option. Pubmed and google scholar were searched for relevant articles using key words. Data were extracted based on authors, year, aims, sample and results. Success rates for women aged 40 or over with clomiphene, IUI, IUI with FSH are all extremely low, at less than 1 % live birth per cycle. However, IVF offers a success rate of around 13.7 % per cycle. An exploration of the effectiveness of available treatment options for older infertile women using their own gametes suggests that IVF offers the best prospects of success. Attempting treatments other than IVF will delay conception unnecessarily.
引用
收藏
页码:667 / 671
页数:5
相关论文
共 39 条
[1]   Intrauterine insemination [J].
Aboulghar, M. ;
Baird, D. T. ;
Collins, J. ;
Evers, J. L. H. ;
Fauser, B. C. J. M. ;
Lambalk, C. B. ;
Somigliana, E. ;
Sunde, A. ;
Tarlatzis, B. ;
Crosignani, P. G. ;
Devroey, P. ;
Diczfalusy, E. ;
Diedrich, K. ;
Fraser, L. ;
Geraedts, J. P. M. ;
Gianaroli, L. ;
Glasier, A. ;
Van Steirteghem, A. .
HUMAN REPRODUCTION UPDATE, 2009, 15 (03) :265-277
[2]   Biological versus chronological ageing of oocytes, distinguishable by raised FSH levels in relation to the success of IVF treatment [J].
Akande, VA ;
Fleming, CF ;
Hunt, LP ;
Keay, SD ;
Jenkins, JM .
HUMAN REPRODUCTION, 2002, 17 (08) :2003-2008
[3]   Biological versus chronological ovarian age: implications for assisted reproductive technology [J].
Alviggi, Carlo ;
Humaidan, Peter ;
Howles, Colin M. ;
Tredway, Donald ;
Hillier, Stephen G. .
REPRODUCTIVE BIOLOGY AND ENDOCRINOLOGY, 2009, 7 :101
[4]   Assisted reproductive technology in Europe, 2004: results generated from European registers by ESHRE [J].
Andersen, A. Nyboe ;
Goossens, V. ;
Ferraretti, A. P. ;
Bhattacharya, S. ;
Felberbaum, R. ;
de Mouzon, J. ;
Nygren, K. G. .
HUMAN REPRODUCTION, 2008, 23 (04) :756-771
[5]   Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE [J].
Andersen, A. Nyboe ;
Goossens, V. ;
Bhattacharya, S. ;
Ferraretti, A. P. ;
Kupka, M. S. ;
de Mouzon, J. ;
Nygren, K. G. .
HUMAN REPRODUCTION, 2009, 24 (06) :1267-1287
[6]   Fertility and ageing [J].
Baird, DT ;
Collins, J ;
Egozcue, J ;
Evers, LH ;
Gianaroli, L ;
Leridon, H ;
Sunde, A ;
Templeton, A ;
Van Steirteghem, A ;
Cohen, J ;
Crosignani, PG ;
Devroey, P ;
Diedrich, K ;
Fauser, BCJM ;
Fraser, J ;
Glasier, A ;
Liebaers, I ;
Mautone, G ;
Penney, G ;
Tarlatzis, B .
HUMAN REPRODUCTION UPDATE, 2005, 11 (03) :261-276
[7]   Investigation of the infertile couple - Investigation of the infertile couple in the era of assisted reproductive technology: a time for reappraisal [J].
Balasch, J .
HUMAN REPRODUCTION, 2000, 15 (11) :2251-2257
[8]   Which career first? The most secure age for childbearing remains 20-35 [J].
Bewley, S ;
Davies, M ;
Braude, P .
BMJ-BRITISH MEDICAL JOURNAL, 2005, 331 (7517) :588-589
[9]   Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial [J].
Bhattacharya, S. ;
Harrild, K. ;
Mollison, J. ;
Wordsworth, S. ;
Tay, C. ;
Harrold, A. ;
McQueen, D. ;
Lyall, H. ;
Johnston, L. ;
Burrage, J. ;
Grossett, S. ;
Walton, H. ;
Lynch, J. ;
Johnstone, A. ;
Kini, S. ;
Raja, A. ;
Templeton, A. .
BMJ-BRITISH MEDICAL JOURNAL, 2008, 337 (7666) :387-390
[10]   Anti-Mullerian hormone as a predictor of pregnancy following IVF [J].
Bhide, Priya ;
Gudi, Anil ;
Shah, Amit ;
Timms, Peter ;
Grayson, Kate ;
Homburg, Roy .
REPRODUCTIVE BIOMEDICINE ONLINE, 2013, 26 (03) :247-252