Female fertility decreases with age. A decline in oocyte quality plays a key role in reproductive problems in older women. Whether advanced maternal age (AMA) is associated with a decline in endometrial receptivity (ER) remains controversial. A systematic review and meta-analysis were conducted to evaluate the relationship between AMA and ER. Eighteen eligible studies were included in this meta-analysis. Of the 18 studies, 17, 8, 14, and 9 studies reported the impact of AMA on clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), respectively. The combined results showed a trend (without significance) toward lower CPR in women with AMA than in younger women. A similar trend of worse outcomes in terms of IR was observed in women with AMA. A significantly higher MR and lower LBR were observed in infertile women with AMA than in younger women. In conclusion, there was a slightly lower IR and CPR without significance; however, significantly increased MR and decreased LBR were observed in women with AMA than in younger women, indicating that AMA is related to the decline of ER. Further prospective cohort studies with a preimplantation genetic testing for aneuploidy model are needed to observe the relationship between AMA and ER and explore the possible mechanisms.
Objective This study aimed to evaluate the effect of female age on pregnancy outcomes of couples with PGT-A treatment and to find potential correlations or trends.Methods A multicenter retrospective study was conducted among women with pre-implantation testing for aneuploidy (PGT-A) cycles from three reproductive centers in China. They were divided into four groups according to female age (Group A: <30 years old, Group B: 30–34, Group C: 35–39, and group D: ≥40). The primary outcome was the clinical pregnancy rate (CPR) and the live birth rate (LBR). secondary outcomes were the biochemical pregnancy rate (BPR), early miscarriage rate (EMR), and preterm birth rate (PBR).Results A total of 603 PGT-A cycles were included in the present study. There were 161, 256, 147, and 39 cycles in Group A, B, C, D, respectively. The CPR was 53.8% in Group D, which was decreased compared with Group A (60.2%), Group B (56.3%), and Group C (59.2%). The LBRs were 52.8%, 48.4%, 42.9%, and 41.0%, respectively. EMRs were 11.3%,9.7%,24.1%, 23.8%. And PBRs were 4.7%, 7.3%, 9.1%, and 25.0% in Group A, B, C, and D, respectively. The EMR and PBR showed significantly different among groups. Binary Logistic regression analysis indicated maternal age affects the live birth rate (OR 0.937, 95%CI 0.883–0.995), Early miscarriage rate (OR 1.148, 95%CI 1.033–1.275) and Preterm birth rate (OR 1.196, 95%CI 1.017–1.405).Conclusion As pregnancy outcomes tend to decrease with maternal age after euploid embryo transfer. The results indicated that endometrial receptivity, another key factor for embryo implantation, was affected by female age. During the ART treatment for women with advanced maternal age, we should not only pay attention to oocyte/embryos quality, but also emphasize endometrial receptivity.
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