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Fortpflanzung im höheren Alter

Spontankonzeption und Eizellspende

Reproduction in old age

Spontaneous conception and oocyte donation

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Hintergrund

Schwangerschaften mit eigenen und fremden Eizellen nach dem 40. Lebensjahr gehen mit gemeinsamen Problemen einher, die durch das Alter der Frau oder mögliche Veränderungen der Gebärmutter, z. B. Myome, bedingt sein können.

Zielsetzung und Methoden

Im vorliegenden Beitrag sollen die Einflüsse und Auswirkungen eines fortgeschrittenen Alters auf den Schwangerschaftsverlauf zusammengefasst werden. Dabei wird sowohl auf die Situation nach Spontankonzeption mit eigenen Eizellen als auch auf die Verhältnisse nach Eizellspende eingegangen. Zu diesem Zweck wurde eine Literaturrecherche durchgeführt.

Ergebnisse

Altersabhängig entwickelt sich in der Schwangerschaft häufiger ein Gestationsdiabetes, Hypertonus oder eine Präeklampsie. Bei Konzeption mit eigenen Eizellen dominiert das Abortproblem, das durch die Aneuploidierate der Eizellen bedingt ist. Bei Eizellspende ist die Fehlgeburtenrate aufgrund des jüngeren Alters der Spenderin geringer. Allerdings ist die Wahrscheinlichkeit von Hypertonus und Präeklampsie ebenfalls erhöht. Weiterhin haben psychosoziale Aspekte eine Bedeutung, da die natürlichen Kräfte, die für die Betreuung der Kinder notwendig sind, abnehmen.

Schlussfolgerung

Der Arzt sollte der älteren Patientin bzw. dem Paar eine intensive Beratung bezüglich der aufgeführten Probleme anbieten.

Abstract

Background

Pregnancies with autologous or donated oocytes above the age of 40 years are both associated with the same problems, which can be caused by the age of the women or possible alterations of the uterus, e.g. leiomyomas.

Objective and methods

In this article the influential factors and effects of advanced age on the course of pregnancy are summarized. The situation after spontaneous conception with autologous oocytes as well as the conditions after oocyte donation are discussed. This was accomplished by carrying out a literature search.

Results

Gestational diabetes, hypertension and preeclampsia develop more frequently during pregnancy in an age-dependent manner. In the case of conception with autologous oocytes the dominant problem is miscarriage, which is caused by the rate of aneuploidy of the oocytes. In the case of donor oocytes the rate of miscarriage is lower due to the younger age of the donor; however, the probability of hypertension and preeclampsia is also increased. Furthermore, psychosocial aspects are important because the natural strengths of the mother, which are necessary for caring for children decrease with age.

Conclusion

Physicians should offer older female patients or couples an intensive counseling with respect to these problems.

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Literatur

  1. Barton JR, Bergauer NK, Jacques DI, Coleman SK, Stanziano GJ, Sibai BM (1997) Does advanced maternal age affect pregnancy outcome in women with mild hypertension remote from term? Am J Obstet Gynecol 176(6):1236–1240, 1240–1243

    Article  CAS  PubMed  Google Scholar 

  2. Bongain A, Castillon JM, Isnard V, Benoit B, Donzeau M, Gillet JY (1998) In vitro fertilization in women over 40 years of age. A study on retrospective data for eight years. Eur J Obstet Gynecol Reprod Biol 76(2):225–231

    Article  CAS  PubMed  Google Scholar 

  3. Bundesärztekammer (2006) (Muster-) Richtlinien zur Durchführung der assistierten Reproduktion (Novelle 2006). Dtsch Arztebl 103(20):A1392–A1403

    Google Scholar 

  4. Canhaço EE, Bergamo AM, Lippi UG, Lopes RGC (2015) Perinatal outcomes in women over 40 years of age compared to those of other gestations. Einstein 13(1):58–64

    Article  PubMed  Google Scholar 

  5. Casey P, Readings J, Blake L, Jadva V, Golombok S (2009) Child development and parent-child relationships in surrogacy, egg donation and donor insemination families at age 7 Abstracts of the 24th Annual Meeting of the ESHRE, Barcelona, Spain, 7–9 July.

    Google Scholar 

  6. Casey P, Jadva V, Readings J, Blake L, Golombok S (2011) Fathers in assisted reproduction families: quality of parenting, psychological well-being, and father-child relationship at age 7 Abstracts of the 27th Annual Meeting of the ESHRE, Stockholm, Sweden, 3–6 July.

    Google Scholar 

  7. CDC (2015) Assisted Reproductive Technology (ART). Report. Network success rate: 2013 national summary. www.cdc.gov/art. Zugegriffen: Februar 2016

    Google Scholar 

  8. CDC (2016) ART – Cycles using donor eggs 2010. www.cdc.gov/art. Zugegriffen: Februar 2016

    Google Scholar 

  9. Deutscher Bundestag (1989) Drucksache 11/5460 vom 25.10.1989

  10. Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U (2015) Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe Frauenheilkd 75(8):827–832

    Article  PubMed  PubMed Central  Google Scholar 

  11. DIR (2015) Deutsches IVF-Register. Jahrbuch 2014. Ärztekammer Schleswig Holstein. J Reproduktionsmed Endokrinol 2015(12):6

    Google Scholar 

  12. Dunson DB, Baird DD, Colombo B (2004) Increased infertility with age in men and women. Obstet Gynecol 103:51–56

    Article  PubMed  Google Scholar 

  13. ESHRE Task Force on Ethics and Law (2002) Gamete and embryo donation. Hum Reprod 17:1407–1408

    Article  Google Scholar 

  14. Franasiak JM, Forman EJ, Hong KH, Werner MD, Upham KM, Treff NR, Scott RT (2014) The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril 101(3):656–663e1

    Article  PubMed  Google Scholar 

  15. Gilbert WM, Nesbitt TS, Danielsen B (1999) Childbearing beyond age 40: pregnancy outcome in 24.032 cases. Obstet Gynecol 93(1):9–14

    CAS  PubMed  Google Scholar 

  16. Golombok S, Murray C, Brinsden P, Abdalla H (1999) Social versus biological parenting: family functioning and the socioemotional development of children conceived by egg or sperm donation. J Child Psychol Psychiatry 40(4):519–527

    Article  CAS  PubMed  Google Scholar 

  17. Golombok S, Jadva V, Lycett E, Murray C, MacCallum F (2005) Families created by gamete donation: follow-up at age 2. Hum Reprod 20:286–293

    Article  CAS  PubMed  Google Scholar 

  18. Hagman A, Loft A, Wennerholm UB, Pinborg A, Bergh C, Aittomäki K, Nygren KG, Romundstad LB, Hazekamp J, Söderström-Anttila V (2013a) Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome: a Nordic cohort study. Hum Reprod 28(6):1598–1609

    Article  PubMed  Google Scholar 

  19. Hagman A, Källen K, Bryman I, Landin-Wilhelmsen K, Barrenäs ML, Wennerholm UB (2013b) Morbidity and mortality after childbirth in women with Turner karyotype. Hum Reprod 28(7):1961–1973

    Article  CAS  PubMed  Google Scholar 

  20. HFEA (2014) Fertility treatment in 2013. HFEA 2014. www.hfea.gov.uk. Zugegriffen: Februar 2016

    Google Scholar 

  21. Ilioi EC, Jadva V, Golombok S (2015) A longitudinal study of families created by reproductive donation: Follow-up at adolescence. Fertil Steril 104(3 Suppl):e26–2015 (ASRM Abstracts)

    Article  Google Scholar 

  22. Kentenich H, Griesinger G (2013) Zum Verbot der Eizellspende in Deutschland: Medizinische, psychologische, juristische und ethische Aspekte. J Reproduktionsmed Endokrinol 10(5–6):273–278

    Google Scholar 

  23. Koo YJ, Ryu HM, Yang JH, Lim JH, Lee JE, Kim MY, Chung JH (2012) Pregnancy outcomes according to increasing maternal age. Taiwan. J Obstet Gynecol 51(1):60–65

    Google Scholar 

  24. Kupka M, Technology AR (2015) ART) in Europe 2012 (2015) Preliminary result generated from European registers by ESHRE ESHRE Annual Meeting. June 16. 2015.

    Google Scholar 

  25. Max-Planck-Institut für ausländisches und internationales Strafrecht (2007) http://www.mpicc.de/meddb/. Zugegriffen: Februar 2016

  26. Nybo AAM, Wohlfahrt J, Christens P, Olsen J, Melbye M (2000) Maternal age and fetal loss: population based register linkage study. BMJ 320(7251):1708–1712

    Article  Google Scholar 

  27. Pecks U, Maass N, Neulen J (2011) Eizellspende – ein Risikofaktor für Schwangerschaftshochdruck. Dtsch Arztebl 108(3):23–31

    Google Scholar 

  28. Sahuquillo S, Meseguer M, Martinez A, Fernández V, Jiménez L, Borgonoz A, Pellicer A, Alamà P (2011) The incidence of minor and serious complications related to controlled ovarian stimulation and oocyte retrieval in oocyte donors Abstract of the 27th Annual Meeting of ESHRE, Stockholm Sweden, 3 July–6 July, i57.

    Google Scholar 

  29. Schneider JP, Kramer W (2009) Retrospective study of U.S. egg donors: risk, formed consent, anonymity, satisfaction & need for long-term follow-up: results & recommendations 25th Annual Meeting ESHRE Amsterdam, June 30th..

    Google Scholar 

  30. Schover L, Collins R, Quigley M, Blankstein J, Kanoti G (1991) Psychological follow-up of women evaluated as oocyte donors. Hum Reprod 6:1487–1491

    CAS  PubMed  Google Scholar 

  31. Schwartz D, Malaux MJ (1982) Female fecundity as a function of age: results of artificial insemination in 2193 nullipaous women with azoospermic husbands. Fedoration CECOS. N Engl J Med 306:404–406

    Article  CAS  PubMed  Google Scholar 

  32. Shenfield F, de Mouzon J, Pennings G, Ferraretti AP, Nyboe AA, de Wert G, Goossens V (2010) Cross border reproductive care in six European countries. Hum Reprod 25:1361–1368

    Article  CAS  PubMed  Google Scholar 

  33. Simchen MJ, Yinon Y, Moran O, Schiff E, Sivan E (2006) Pregnancy outcome after age 50. Obstet Gynecol 108(5):1084–1088

    Article  PubMed  Google Scholar 

  34. Söderström-Anttila V, Sajaniemi N, Tiitinen A, Hovatta O (1998) Health and development of children born after oocyte donation compared with that of those born after in-vitro-fertilization, and parents’ attitudes regarding secrecy. Hum Reprod 13:2009–2015

    Article  PubMed  Google Scholar 

  35. Söderström-Anttila V (2001) Pregnancy and child outcome after oocyte donation. Hum Reprod Update 7:28–32

    Article  PubMed  Google Scholar 

  36. Statistisches Bundesamt (2016) https://www.destatis.de/DE/ZahlenFakten/GesellschaftStaat/Bevoelkerung/Geburten/Tabellen/LebendgeboreneBioAlter.html. Zugegriffen: Februar 2016

    Google Scholar 

  37. Stoop D, Baumgarten M, Haentjens P, Polyzos NP, de Vos M, Verheyen G, Camus M, Devroey P (2012) Obstetric outcome in donor oocyte pregnancies: a matched-pair analysis. Reprod Biol Endocrinol. doi:10.1186/1477-7827-19-42

    PubMed  PubMed Central  Google Scholar 

  38. Storgaard MB (2015) Risk of preeclampsia and hypertensive disorders of pregnancy (HDP) in singleton and twin oocyte donation (OD) pregnancies – a systematic review and meta-analysis ESHRE Annual meeting 2015. Poster 565.

    Google Scholar 

  39. Strowitzki T (2013) Infertilität bei Frauen – Neueste Entwicklungen. Bundesgesundheitsblatt 56:1628–1632

    Article  CAS  Google Scholar 

  40. Thurin-Kiellberg A (2015) Maternal and perinatal outcomes in oocyte donation pregnancies in Sweden 2003–2012 ESHRE Annual meeting 2015. Poster 588.

    Google Scholar 

  41. Timofeev J, Reddy UM, Huang CC, Driggers RW, Landy HJ, Laughon SK (2013) Obstetric complications, neonatal morbidity, and indications for cesarean delivery by maternal age. Obstet Gynecol 122(6):1184–1195

    Article  PubMed  PubMed Central  Google Scholar 

  42. Toner J (2003) Age = egg quality, FSH level = egg quantity. Comment. Fertil Steril 79(3):491

    Article  PubMed  Google Scholar 

  43. Tsafrir A, Simon A, Revel A, Reubinoff B, Lewin A, Laufer N (2007) Retrospective analysis of 1217 IVF cycles in women aged 40 years and older. Reprod Biomed Online 14(3):348–355

    Article  CAS  PubMed  Google Scholar 

  44. Van der Hoorn MLP, Lashley EELO, Bianchi DW, Claas FHJ, Schonkeren CMC, Scherjon SA (2010) Clinical and immunologic aspects of egg donation pregnancies: a systematic review. Hum Reprod Update 16(6):704–712

    Article  PubMed  Google Scholar 

  45. Vercammen D, Stoop D, De Vos M, Polyzos NP, Nekkebroeck J, Devroey P (2011) Oocyte donation does not affect future reproductive outcome. A follow-up study. Abstract of the 27th Annual Meeting of ESHRE, Stockholm Sweden, 3 July–6 July, i262.

    Google Scholar 

  46. Ziadeh S, Yahava A (2001) Pregnancy outcome at age 40 and older. Arch Gynecol Obstet 256(1):30–33

    Article  Google Scholar 

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Authors and Affiliations

  1. Fertility Center Berlin, Spandauer Damm 130, 14050, Berlin, Deutschland

    H. Kentenich & A. Jank

  2. Abteilung für Geburtsmedizin, Universitätsfrauenklinik Leipzig, Leipzig, Deutschland

    A. Jank

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Correspondence to H. Kentenich.

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Interessenkonflikt

H .Kentenich hält Vorträge auf Veranstaltungen der Firmen Dr. KADE und TEVA. A. Jank gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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C. Gnoth

G. Griesinger

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Kentenich, H., Jank, A. Fortpflanzung im höheren Alter. Gynäkologische Endokrinologie 14, 105–110 (2016). https://doi.org/10.1007/s10304-016-0062-6

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