Outcome of in vitro fertilization in women 45 years and older who use autologous oocytes

Objective

To determine the IVF outcome in women over the age of 44 years.

Design

Retrospective analysis.

Setting

University-based IVF center.

Patient(s)

Two hundred eighty-eight consecutive IVF cycles in women over the age of 44 years.

Intervention(s)

IVF.

Main Outcome Measure(s)

Ovarian response and cycle outcome.

Results

The mean age of the patients was 45.4 (±0.73) years, with a range of 45–49 years. Fifty-seven of 288 (19.8%) did not start because of an elevated FSH or ovarian cyst. Just over 30% (70/231) had their cycle cancelled before retrieval. The mean number of oocytes was 6.8 (±3.8), and the mean number of fertilized zygotes was 5.4 (±3.4). On average, the mean numbers of embryos replaced were 3.2 (±1.5). An overall pregnancy rate of 21.1% (34/161) per retrieval was found. Of these, 85.3% (29/34) experienced a pregnancy loss. The overall delivery rate was 3.1% (5/161) per retrieval. Only patients at 45 years of age with a good response (>5 oocytes) achieved a delivery.

Conclusion(s)

We have shown that IVF is a reasonable option for women of very advanced maternal age (>44 years) but is limited to those at the age of 45 years with a response of >5 oocytes.

Key Words: IVF, maternal age, IVF outcome