Outcome of assisted reproductive technology in women over the age of 41

Objective: To analyze the results of ongoing pregnancies and deliveries after assisted reproductive technology (ART) in women aged greater than or equal to 41 years, stratified by year of age. Design: Retrospective study. Setting: University hospital, IVF unit. Patient(s): A total of 431 IVF and intracytoplasmic sperm injection (ICSI) cycles were initiated in women greater than or equal to 41 years of age. Intervention(s): Medical files of ART patients and pregnancy outcomes were reviewed. Main Outcome Measure(s): Oocytes retrieved, embryos developed, and clinical pregnancy and delivery rates. Result(s): Of the 431 started cycles, 376 (87%) reached the oocyte retrieval stage. The mean number of oocytes aspirated per patient was 5.4 +/- 0.9 and 6.7 +/- 1.2 in the IVF and ICSI cycles, respectively, and the number of embryos obtained was 2.3 +/- 1.3 and 2.8 +/- 1.6 in the NF and ICSI cycles, respectively. The number of transferable embryos was 2.0 +/- 1.2 and 2.5 +/- 0.8. The pregnancy rate per oocyte pickup (OPU) was 12.4%; however, the delivery rate per OPU was 4.5%. The mean delivery rate per OPU among women aged 41-43 years was 2%-7%. There were no deliveries aged greater than or equal to 44 years and no pregnancies at the age of 45 years. The pregnancy and delivery rates of the ICSI and IVF patients were similar after stratification by age. Conclusion(s): In our studies, ART performed with homologous oocytes, whether by IVF or ICSI, yielded no clinical pregnancies among women aged greater than or equal to 45 years and no deliveries aged greater than or equal to 44 years. The mean delivery rate per oocyte retrieval among women aged 41-43 years varied between 2% and 7%. (Fertil Steril(R) 2000; 74:471-5. (C) 2000 by American Society for Reproductive Medicine.).