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.