Volume 9, Issue 4 (7-2011)                   IJRM 2011, 9(4): 281-0 | Back to browse issues page

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Aflatoonian A, Eftekhar M, Mohammadian F, Yousefnejad F. Outcome of assisted reproductive technology in women aged 40 years and older. IJRM. 2011; 9 (4) :281-0
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-244-en.html
1- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran , Mohammadian_ farnaz@yahoo.com
Abstract:   (1039 Views)
Background: Human fertility has been declined all over the world. Advanced women’s age is one of the most important factors in determining the success of reproduction and ageing has negative impact on ART outcome and advanced female age decreases the chance of live birth rates achieved using ART, especially after 40 years of age.
Objective: To evaluate  ART outcomes regarding to pregnancy, abortion, cycle cancellation and live birth rates in women 40 years and older.
Materials and Methods: A retrospective study was performed on three hundred-thirteen women undergoing ART cycles in the Madar Hospital in Yazd. Women with age ≥ 40 years who indicated for ART enrolled the study regardless of the infertility type or etiology. In this study, we used data from IVF or ICSI cycles using fresh embryo transfer. Follow up was performed in regard to pregnancy, abortion, cycle cancellation and live birth rates.
Results: The mean age of women was 41.87±1.97 years. Chemical pregnancy rate was 8.6% (27/313) per cycle. Clinical pregnancy rate was 3.8% (12/313) per cycle. Spontaneous abortion was observed in 63% (17/27) of patients with positive pregnancy test. The overall cancellation rate was 23.3% per oocytes retrieval. The overall live birth rate per cycle for all women who initiated an ART cycle at age ≥40 years was 3.2% (10/313) that eight of those women were under 42 years old.
Conclusion: Based on our results, we suggest that women with age 42 years and above should be advised to use other options, including oocyte donation or adoption.
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Type of Study: Original Article |

1. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update 2008; 14: 605-621. [DOI:10.1093/humupd/dmn042]
2. Skakkebæk NE, Jørgensen N, Main KM, Meyts ERD, Leffers H, Andersson AM, et al. Is human fecundity declining? Int J Andrology 2006; 29: 2-11. [DOI:10.1111/j.1365-2605.2005.00573.x]
3. Stephen EH, Chandra A. Declining estimates of infertility in the United States: 1982-2002. Fertili Steril 2006; 86: 516-523. [DOI:10.1016/j.fertnstert.2006.02.129]
4. Lass A, Croucher C, Duffy S, Dawson K, Margara R, Winston RML. One thousand initiated cycles of in vitro fertilization in women ≥40 years of age. Fertil Steril 1998; 70: 1030-1034. [DOI:10.1016/S0015-0282(98)00353-7]
5. Ron-El R, Raziel A, Strassburger D, Schachter M, Kasterstein E, Friedler S. Outcome of assisted reproductive technology in women over the age of 41. Fertil Steril 2000; 74: 471-475. [DOI:10.1016/S0015-0282(00)00697-X]
6. Piette C, de Mouzon J, Bachelot A, Spira A. In-vitro fertilization: influence of women's age on pregnancy rates. Hum Reprod 1990; 5: 56-59. [DOI:10.1093/oxfordjournals.humrep.a137041]
7. Serour G, Mansour R, Serour A, Aboulghar M, Amin Y, Kamal O, et al. Analysis of 2,386 consecutive cycles of in vitro fertilization or intracytoplasmic sperm injection using autologous oocytes in women aged 40 years and above. Fertil Steril 2010; 94: 1707-1712. [DOI:10.1016/j.fertnstert.2009.09.044]
8. Karimzadeh MA, Ghandi S. Age and basal FSH as a predictor of ART outcome. Iran J Reprod Med 2009; 7: 19-22.
9. Geng L, Li W, Li X, Qin L, Xiao Z, Li S. Controlled ovarian hyperstimulation interventions in infertile women aged 40 years or older undergoing in-vitro fertilization. Int J Obstet Gynecol 2009; 106: 193-197. [DOI:10.1016/j.ijgo.2009.03.055]
10. George K, Kamath MS. Fertility and age. J Hum Reprod Sci 2010; 3: 121. [DOI:10.4103/0974-1208.74152]
11. ESHRE Capri Workshop Group. Fertility and ageing. Hum Reprod Update 2005 May 1, 2005; 11: 261-276. [DOI:10.1093/humupd/dmi006]
12. Bongain A, Castillon JM, Isnard V, Benoit B, Donzeau M, Gillet JY. In vitro fertilization in women over 40 years of age. A study on retrospective data for eight years. Eur J Obstet Gynecol Reprod Biol 1998; 76: 225-231. [DOI:10.1016/S0301-2115(97)00210-8]
13. Klipstein S, Regan M, Ryley DA, Goldman MB, Alper MM, Reindollar RH. One last chance for pregnancy: a review of 2,705 in vitro fertilization cycles initiated in women age 40 years and above. Fertil Steril 2005; 84: 435-445. [DOI:10.1016/j.fertnstert.2005.02.020]
14. Von Wald T, Monisova Y, Hacker MR, Yoo SW, Penzias AS, Reindollar RR, et al. Age-related variations in follicular apolipoproteins may influence human oocyte maturation and fertility potential. Fertil Steril 2010; 93: 2354-2361. [DOI:10.1016/j.fertnstert.2008.12.129]
15. Griffiths A, Dyer SM, Lord SJ, Pardy C, Fraser IS, Eckermann S. A cost-effectiveness analysis of in-vitro fertilization by maternal age and number of treatment attempts. Hum Reprod 2010; 25: 924-931. [DOI:10.1093/humrep/dep418]
16. Sullivan E, Wang Y, Chapman M, Chambers G. Success rates and cost of a live birth following fresh assisted reproduction treatment in women aged 45 years and older, Australia 2002-2004. Hum Reprod 2008; 23: 1639-1643. [DOI:10.1093/humrep/den102]
17. Widra EA, Gindoff PR, Smotrich DB, Stillman RJ. Achieving multiple-order embryo transfer identifies women over 40 years of age with improved in vitro fertilization outcome. Fertil Steril 1996; 65: 103-108. [DOI:10.1016/S0015-0282(16)58035-2]
18. Ernest Hung Yu Ng, Pak Chung Ho. Ageing and ART: a waste of time and money? Best practice & research. Clin Obstet Gynaecol 2007; 21: 5-20. [DOI:10.1016/j.bpobgyn.2006.09.004]
19. Grimbizis G, Vandervorst M, Camus M, Tournaye H, Van Steirteghem A, Devroey P. Intracytoplasmic sperm injection, results in women older than 39, according to age and the number of embryos replaced in selective or non-selective transfers. Hum Reprod 1998; 13: 884-889. [DOI:10.1093/humrep/13.4.884]
20. Tsafrir A, Simon A, Revel A, Reubinoff B, Lewin A, Laufer N. Retrospective analysis of 1217 IVF cycles in women aged 40 years and older. Reprod Biomed Online 2007; 14: 348-355. [DOI:10.1016/S1472-6483(10)60878-4]
21. Spandorfer SD, Davis OK, Barmat LI, Chung PH, Rosenwaks Z. Relationship between maternal age and aneuploidy in in vitro fertilization pregnancy loss. Fertil Steril 2004; 81: 1265-1269. [DOI:10.1016/j.fertnstert.2003.09.057]
22. Spandorfer SD, Bendikson K, Dragisic K, Schattman G, Davis OK, Rosenwaks Z. Outcome of in vitro fertilization in women 45 years and older who use autologous oocytes. Fertil Steril 2007; 87: 74-76. [DOI:10.1016/j.fertnstert.2006.05.081]
23. Harrison KL, Breen TM, Hennessey JF, Hynes MJ, Keeping JD, Kilvert GT, et al. Patient age and success in a human IVF programme. Aust N Z J Obstet Gynaecol 1989; 29: 326-328. [DOI:10.1111/j.1479-828X.1989.tb01755.x]
24. Dew JE, Don RA, Hughes GJ, Johnson TC, Steigrad SJ. The Influence of Advanced Age on the Outcome of Assisted Reproduction. J Assist Reprod Genet 1998; 15: 210-214. [DOI:10.1023/A:1023004503697]
25. Chuang CC, Chen CD, Chao KH, Chen SU, Ho HN, Yang YuS. Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril 2003; 79: 63-68. [DOI:10.1016/S0015-0282(02)04562-4]
26. Henne MB, Stegmann BJ, Neithardt AB, Catherino WH, Armstrong AY, Kao TC, et al. The combined effect of age and basal follicle-stimulating hormone on the cost of a live birth at assisted reproductive technology. Fertil Steril 2008; 89: 104-110. [DOI:10.1016/j.fertnstert.2007.02.016]

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