1994년 1월 1일부터 1995년 12월 31일간에 삼성제일병원 산부인과 불임크리닉에서 체외수정시술후 질초음파로 태아심박동이 확인된 338예에서 다음과 같은 결과를 얻었다. 1. 전체 임신손실율은 8.0%(27/338)로 29세이하에 서 6.2%(8/130), 30∼34세에서 7.5%(12/161), 35∼ 39세에서 15.8%(6/138), 40세이상에서 11.1%(1/9)였 다. 2. 다인자(월경주기 제 3일째의 혈중 LH, FSH, E2의 농도, 다태임신감수술 시행 유무, 불임의 원인, 과배란유도 방법, 환자의 나이)와 임신손실에 있어 서 임신손실율을 logistis regression analysis로 비 교한 결과 환자의 나이만이 통계적으로 의의가 있었 으며(p＜0.05) 환자의 연령이 증가함에 따라 임신손 실율이 의의 있게 증가하는 예측도를 구할 수 있었 다. 이상의 결과로 불임환자에서 체외수정시술후 질 초음파로 태아심박동이 확인 되었다고 해도 일반 산 모에 비해 임신손실율이 높으며 고령의 산모(35세 이상)에서는 임신손실이 일어날 가능성이 연령이 낮 은 환자 (34세이하)에 비해 의의 있게 크다. 따라서 체외수정시술을 받고자 하는 고령의 환자에서는 충 분한 상담이 필요하며 본 연구가 유용한 자료가 될 것으로 사료된다.

In infertile patients, the pregnancy loss rate after demonstration of fetal heart beat ranges about 7 % to 11 %, which is relatively higher than that of normal population(about 1.5∼3.3 %). But scanty data are available in evaluation of the influence of maternal age on pregnancy outcomes in IVF-ET patients. Thus, this study was done to assess the imp-act of maternal age on pregnancy loss rate after the early sonographic detection of fetal cardiac activity following IVF-ET. Pregnancy outcomes of 338 IVF-ET cycles from January 1, 1994 through December 31, 1995 were analyzed. Trans vaginal ultrasonography was done serially from the day 21 postconception and the presence of fetal heart activity was documented using a Samsung 125-MAX scanner with a 6.5-MHz transvaginal probe. Logistic regression analysis was done to determine the possible effects of various independent factors such as treatment pr- otocol, infertility factors, basal LH, FSH and E2, multifetal pregnancy reduction, and age of the wife, on probability of spontaneous pregnancy loss after confirmation of positive fetal heart beat. The overall pregnancy loss rate was 8.0 %(27/338). The probability of pregnancy loss after positive fetal heart beat increased with age of the wife(logistic regression analysis, P＜0.05). The probability of spontaneous pregnancy loss at a given age was expressed as the following formula：probability＝ex/(1＋ex), in which χ＝-3.9＋0.2×age. The older women age over 35 had approximately twice the pregnancy loss rate compared to the younger women；14.9 %(7/47) vs. 6.9 %(20/291). The pregnancy loss rate after multifetal pregnancy reduction was 9.8 %(6/61), which was not significantly different from tht 7.6 %(21/277) without multifetal pregnancy reduction(p＞0.05). We conclude that spontaneous pregnancy loss rate after documentation of fetal cardiac activity increases as a function of the maternal age and a profound effect was observed after age 35. Thus, older patients should be counselled on the higher risk of spontaneous pregnancy loss.