本文選題：高齡 + 不孕癥��； 參考：《中華生殖與避孕雜志》2017年02期

【摘要】：隨著越來(lái)越多的育齡夫婦推遲其生育計(jì)劃,以及我國(guó)“二孩政策”全面放開(kāi),高齡希望生育父母的比例逐漸增加。然而,隨著女性年齡增加,卵巢功能逐漸下降,且子宮肌瘤、瘢痕子宮、盆腔炎癥等發(fā)生率顯著增加,不孕癥的發(fā)生率逐漸增加。高齡女性即使通過(guò)輔助生殖技術(shù)(ART)獲得成功妊娠,妊娠并發(fā)癥風(fēng)險(xiǎn)和內(nèi)、外科合并癥的發(fā)生風(fēng)險(xiǎn)亦會(huì)隨年齡增大而增加,如流產(chǎn)、胎死宮內(nèi)、低出生體質(zhì)量、早產(chǎn)以及妊娠期糖尿病和高血壓疾病等。對(duì)于高齡不孕患者的診治策略目前尚缺乏一致性,患者的診治療效更是參差不齊�；谝陨锨闆r,中國(guó)醫(yī)師協(xié)會(huì)生殖醫(yī)學(xué)專(zhuān)業(yè)委員會(huì)組織生殖內(nèi)分泌及ART專(zhuān)家編寫(xiě)了本“高齡女性不孕診治指南”,希望本指南可以規(guī)范我國(guó)高齡不孕女性患者的診治流程。本指南從高齡女性的生育狀況、需要進(jìn)行的相關(guān)生育力評(píng)估及指標(biāo)解讀以及高齡女性孕前身體和營(yíng)養(yǎng)準(zhǔn)備、咨詢、相關(guān)妊娠風(fēng)險(xiǎn)評(píng)估等入手進(jìn)行深入探討,分析了目前臨床、實(shí)驗(yàn)室的熱點(diǎn)問(wèn)題:高齡女性子代遺傳學(xué)特征及評(píng)估、咨詢以及相應(yīng)的實(shí)驗(yàn)室篩查、診斷方法和操作規(guī)范。另外,對(duì)于高齡女性婦產(chǎn)科及內(nèi)外科合并癥發(fā)生率高的狀況,針對(duì)不同合并癥狀況探討了相應(yīng)的診療規(guī)范。最后,綜合各方面情況制定了高齡女性不孕癥的助孕策略,為高齡不孕女性的診治提供依據(jù)和指導(dǎo)。
[Abstract]:With more and more couples of childbearing age postponing their fertility plans and the "two-child policy" being fully liberalized in China, the proportion of senior citizens who wish to have parents increases gradually. However, with the increase of female age, ovarian function gradually decreased, and the incidence of uterine fibroids, scar uterus, pelvic inflammation and so on increased significantly, and the incidence of infertility increased gradually. Even if successful pregnancy is achieved through assisted reproductive technology (ART), the risk of complications and internal complications of pregnancy and surgical complications also increase with age, such as abortion, intrauterine fetal death, low birth weight. Premature delivery and gestational diabetes mellitus and hypertension, and so on. At present, the diagnosis and treatment strategy for the elderly infertility is still lack of consistency, and the curative effect of diagnosis and treatment is even more uneven. Based on the above situation, the expert on reproductive endocrinology and ART of the professional committee of reproductive medicine of the Chinese Medical Association has compiled the guide for the diagnosis and treatment of infertility in the elderly women, hoping that this guide can standardize the diagnosis and treatment process of the elderly infertile women in China. This guide explores the fertility status of older women, the related fertility assessments and indicators that need to be evaluated, and the physical and nutritional preparation, counseling, and risk assessment of pregnancy for older women before pregnancy, and analyzes the current clinical features. Hot issues in the laboratory: genetic characteristics and evaluation, counseling and corresponding laboratory screening, diagnostic methods and operational specifications for the offspring of older women. In addition, for the elderly women with high incidence of gynecology and obstetrics and internal and surgical complications, the diagnosis and treatment of different complications were discussed. Finally, the strategy of assisted pregnancy for the elderly women with infertility is formulated in order to provide the basis and guidance for the diagnosis and treatment of the elderly infertile women.
【作者單位】： 中國(guó)醫(yī)師協(xié)會(huì)生殖醫(yī)學(xué)專(zhuān)業(yè)委員會(huì);

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