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Premature Ovarian Aging and Infertility

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Title: Premature Ovarian Aging and Infertility Author: CCEB Last modified by: rmc Created Date: 8/16/2004 2:42:26 AM Document presentation format – PowerPoint PPT presentation

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Title: Premature Ovarian Aging and Infertility


1
????? ???? ?????? ?? ?????? ?????? ????????
  • ??? ???, ???? ?????? ??????, ???? ?????? ?????,
    ????.

2
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  • ?????? ?????, ??? ?? ??????? ????? ???? ?? ????.
  • ???? ??????? ??? ????, ????? ???? ?? 6 ?????
    ????? ???????, ?- 400,000 ???? ????????.
  • ???? ??? 35 ?? ???? ???? ?????? ?????? ??????.
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    ???? ?????? ?????? ??????, ???? ????? ??????.
  • ???? ???? ???? ?? ?????? ????? ?????? ??????
    ??????.

3
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4
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5
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  • ??? ????? ??????- ????? ???? ??????.
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    ????????..."
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    ??????? ?????, ????? 10 ???? ????? ?????, ??? ??
    45, ?? ???? ?? ???? ????? ?? ???? 50..."
  • ?????? ??????? ???? ????? ?????????? ?????, ????
    ???? ?? ????? ???? ??????.

6
(No Transcript)
7
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??????! ??????! ????? ??????? ????????? ?????? ??
??? ?? "???????? ?????????", "???????", "?????
???? ?????? ?? ????" ???'. ?????? ?????? ????.
8
?? ????? ????? ????????
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    ??????? ???? ????????.
  • ???? ???? ???????? ???? ??????? ???? ???? ????.
  • ???? ?? ????? ????? ?????? "???????".
  • ?????? ?????? ?????? ?????? (??????, ?????????,
    ????? ????? ????) ?????? ????? ?? ?? ??? ??? ???
    ????? ?????.
  • ????? ??? ?????? ????? ???? ?? ????? ?????? ?????
    ????????????.

9
209 ????, ??????? ??????????, ????? ??? ??? 45,
??????? ????????, ???????
????? ????? ?????? ???? ????????? ????? ?????
?????????? ??????.
???? ?????? ????.
????? ???' 2004
10
????? ????? ?????? ???? ????????? ????? ?????
?????????? ??????.
???? ?????? ????.
??? ?????? ?????? ????? ?? ??? ???????? ????
???????? ??? ???? ?? ????? ??????? ????? ??????
????? ?????????? ??? ?????? ???? "?????" ???
????? ?????? ??????
????????? ???' 2006
11
(No Transcript)
12
?? ????? ?? ???? ???? ???????
  • ???? ???? ????? (gt40 ) ????? ????? ??????
    ???????? ?????????
  • ??? ??? ?? / ???? ?????.
  • ????? ?????.
  • ??????? ??????.
  • ????? ??? ?????? / ??????? ?????.
  • ???? ?????? ????? ???????.
  • ??????? ??????? ????, IUGR, ?????????, ?????
    ????????????, ??????? ?- DNA ???????????.

13
?????? ????? ???? ?????- ??????
  • ???? ????? ?????? ?????????, ????? ???, ????? ???
    ???? ??? ???? ??? ? "age infertility"
  • ???????? ????? ????? ?"? ????? ????? ?????? ???
    ?????.
  • IVF ??? ???? ?? ?????????? ???????? ?????? ????
    ??????? ???????. ????? ?????? ??? ?? ??????
    ????????? ???????????? ? GnRH, ?????????????
    ????? ?? ???? ??? ?? ???? ????? ?? ????????????
    (FSH, LH), ????? ????.
  • ????? ?? DHEA.
  • ????? ??????? ?? ??????.

14
?? ??????? ?? IVF ?????? ?????????
  • ???? ??? ??? 44
  • Mean age 45.4 (45-49) 73 age 45
  • 19.8 FSH high did not start
  • 70 / 231 (30) cycle cancelled
  • 161 remained
  • mean no. of oocytes 6.8
  • fertilized 5.4
  • embryos transferred 3.2
  • Pregnancy rate 21.1 (34/161)
  • Miscarriages - 85.3 (29/34)
  • Delivery rate - 3.1 (5/161)
  • Only women age 45 with at least 5 oocytes
    delivered a live baby.

Spandorfer et al, Fertil Steril, 2007
15
?? ?????
???????? (??????? ???' 2004)
Deliv/Cycle Ab rate PR/ Cycle Pregs Cycles Age
2 70 6.6 47 708 43-45
??? ????? (??? ?? ???' 2000)
Deliv/Cycle Ab rate PR/ Cycle Pregs Cycles Age
4.5 64 12.4 45 431 gt41
?? ??? ????? ??? ??? 44
???? (??????? ???' 2007)
Deliv/Cycle Ab rate PR/ Cycle Pregs Cycles Age
2.5 50 5.4 16 299 44
1 67 1.9 3 154 45
0 0 0 0 55 46
16
??? ?????? ?????? IVF ???? 43?
  • ???
  • ?????? ????? ?? ?????? (???? ? 2 ???? ??)
    ????? ?"?????", ?? ?????.
  • ????? "???????" ????? ?????. ?? ????? ???? ??????
    ?????? ???????.
  • ???
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  • ????????? ?? ??????? ?????? ??????.
  • ????? ?????? ????? ?????? ????? ????? ?? ???? ??
    ??? ????? ??????.

17
??? ???? ????????
  • ??? ??????? ???????? ???? ???? ?????? ?????.
  • ??? ???? ????? ??????? ??????? ????? ???? ?????
    (PGS) ???? ???? ???? ?? ?????? ???????
  • ???? ?????????? ????? ????? ???? ????? ?? ?????.
  • 408 ???? ???? 35 ?? 41

???????? ???' 2007
18
?????? ???, ?? ??? ?? ?? ?? ????... ?????? ??
????????? ???????????
19
??? ???? ?? ????????????????? ???? ??????
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    ???? ?? ????? ?????? ?"? ????? ????????? ??????
    ?????? ??????
  • ????? ?????? ?????? ?? ???? ??????, ?????? ?????
    ?? ???? ????? ???? ????? ???? ??????.

20
(No Transcript)
21
???? ????? ASSISTED HATCHING
????? ????? ????? ?? ?????? ???? ?? ?????? ?????
?????? (???? ???????). ????? ?????? ???? ?? ????
????? ?????? ??? ????? ????? ?? ????? ????. ????
"?????" ????? ???? ?"??????" ?"? ?????
??????. ??????? ?? ?? ???????, ????? ??? ?????
????? ????? ????????.
22
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?? ?????? ????? ???? ???????. ???? ???????
??????? ????? ??? ???? ???? ?????? ??? ???? ?????
????, ?? ??????? ??? ????? ?????? ??.
??? ???' , 2003
23
"????? ??????"
?? ???? ????? ????? ????? ??? ?????, ?????????
???? ?? ????? ?????? ??? ???? ???????
??????? ???????? ????? ???????? ???? ???????????
?? ?????? ?? ??????. ???? ??????? ??????? ???
????, ???? ??????? ?????, ??????? ???????
??????? ?????? ???? ?? IVF ????. ?? ???? ????
????? ?????? ?????? ????? ?? ????? ?????
??????. ???? ??? ???? ?? ????? ?? ????? ????
???? ???? ??????? ???. ?? ????? ?? ????? ???????
???? ?????? ??????. ?? ???? ?????? ?????
?????? IVF ???? ????? ???? 43...
24
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????? ???? ??? ??. ?? ???? ?????? ???? ??????? ??
????????. ?????? ???????? ??????? ?????? ??????
?????? ???? ?? ?????? ???"?.
25
??? ?????
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    ?????? ???? ?????, ??? ????? ?????? ??????? ????
    ???? ?????.
  • ???? ????? ??? ???? ????? ????? ???? ?? ????
    ?????? ???? ??????.
  • ????? ??? ????? ??????? (?????????) ?? ???????.
  • ??? ????? ??? ?? ??????? ????
  • ????? ?????? ????-?????????? ?? ?????? ??????
    ???????.

26
(No Transcript)
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