High-order oocyte transfer in gamete intrafallopian transfer patients 40 or more years of age.
OBJECTIVE
To analyze whether a policy of high-order oocyte transfer would be effective in women > or = 40 years of age who are undergoing GIFT, and further, whether a specific subgroup of these patients could be identified where clinical pregnancy was more likely to occur.


METHODS
Prospective descriptive study.


METHODS
Patients in a university-based reproductive endocrinology and infertility practice.


METHODS
Infertile women > or = 40 years of age who underwent GIFT cycles between January, 1990 and December, 1993 after not having achieved pregnancy with at least three previous cycles of superovulation and intrauterine insemination.


METHODS
Gamete intrafallopian transfer was performed after controlled ovarian hyperstimulation with hMGs. High-order oocyte transfer was employed.


METHODS
Clinical pregnancy rates (PRs).


RESULTS
The overall clinical PR was 24.5% per retrieval (12/49) and 25.5% per transfer (12/47). A significantly higher number of oocytes were retrieved in patients who became pregnant than those who did not. Patient age, cycle day 3 FSH level, E2 level on the day of hCG administration, number of oocytes transferred, and total number of motile sperm transferred did not differ significantly between the two groups. The clinical PR per transfer was significantly higher in patients with more than five oocytes transferred (10/27, 37%) versus those with five or less oocytes transferred (2/20, 10%). No multiple gestations were obtained.


CONCLUSIONS
The number of oocytes retrieved in women > or = 40 years of age undergoing GIFT is the main determinant predicting clinical pregnancy. High-order oocyte transfer seems to lead to a favorable PR while the risk of multiple gestation is limited.
Qasim
S M
SM
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick 08901, USA.
Karacan
M
M
Corsan
G H
GH
Shelden
R
R
Kemmann
E
E
D000328:Adult; D005260:Female; D015181:Gamete Intrafallopian Transfer / Q000379:methods*; D006801:Humans; D008423:Maternal Age; D008596:Menotropins / Q000627:therapeutic use; D009865:Oocytes; D010053:Ovary / Q000187:drug effects; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D013048:Specimen Handling
D008596:Menotropins