Pregnancy loss in the first in vitro fertilization cycle is not predictive of subsequent delivery in women over 40 years

Received 18 September 2006; received in revised form 21 February 2007; accepted 21 February 2007. published online 04 May 2007.

Objective

To determine if there is an association between first IVF cycle outcome and subsequent delivery rate for women over 40 years.

Design

Retrospective data analysis.

Setting

Large, private academically affiliated IVF center.

Intervention(s)

Patients over 40 years of age undergoing IVF.

Main Outcome Measure(s)

Delivery rate compared between patients with a pregnancy loss versus a negative β-hCG in their first cycle. Additional factors including subsequent pregnancy losses, total number of IVF cycles, and delivery rates per cycle were also analyzed.

Result(s)

Among women who underwent their first IVF cycle over age 40, 8% of women had a pregnancy loss and 82% had a negative β-hCG in their initial IVF cycle. In the pregnancy loss and negative β-hCG groups, 17.9% and 21.9%, respectively, had a successful delivery in a future cycle. There were no further pregnancies leading to delivery after the fourth treatment cycle for the pregnancy loss group and the sixth treatment cycle for the negative β-hCG group. The average number of cycles and the number of subsequent pregnancy losses were similar in both groups.

Conclusion(s)

Outcome of initial IVF cycle is not prognostic of future delivery for women over the age of 40 years.

Key Words: ART, advanced maternal age, delivery rates, IVF, pregnancy loss, spontaneous abortion, biochemical pregnancy, ectopic

a Boston IVF, Waltham, Massachusetts

b Beth Israel Deaconess Medical Center, Boston, Massachusetts

c Harvard Medical School, Boston, Massachusetts

Reprint requests: Rita Sneeringer, M.D., Beth Israel Deaconess Medical Center, 330 Brookline Avenue, KS-322, Boston, Massachusetts 02215 (FAX: 617-975-5575).

Conflicts of interest/financial support: none.

Presented at the ASRM meeting 2004, Philadelphia, Pennsylvania.

Present address of Sigal Klipstein: Karande and Associates, 1585 North Barrington Road, Suite 406, Hoffman Estates, Illinois 60194.

Present address of Richard H. Reindollar: Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, New Hampshire 03756.

PII: S0015-0282(07)00508-0

doi:10.1016/j.fertnstert.2007.02.038

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