Three hundred cycles of oocyte donation at the University of Southern California: assessing the effect of age and infertility diagnosis on pregnancy and implantation rates.
OBJECTIVE
Our purpose was to evaluate the effect of age on endometrial receptivity and to compare success rates for oocyte donation among groups with differing primary diagnoses.


METHODS
This was a retrospective analysis of 300 consecutively attempted oocyte donation cycles.


METHODS
The setting was the in vitro fertilization program at the University of Southern California.


METHODS
Recipients were divided into groups according to age: Group I, < 30 years (n = 8); Group II, 30-39 years (n = 59); Group III, 40-49 years (n = 107); and Group IV, 50-59 years (n = 18). Additionally, indications for treatment were divided into Classes A-G according to a primary diagnosis given to each patient and included premature ovarian failure (n = 44), surgical castration (n = 9), genetic disease carrier (n = 12), transitional menopause (n = 27), natural menopause (n = 30), multiple IVF failures (n = 62), and postchemotherapy (n = 8). Recipients received oral micronized estradiol and intramuscular progesterone. Oocytes were donated by fertile young women utilizing ovarian hyperstimulation with menopausal gonadotropins.


RESULTS
There were no significant differences among groups or classes related to either the number of oocytes received or the number of embryos transferred per cycle. Rates for embryo implantation and resorption and the clinical and ongoing or delivered pregnancy rates were similarly not different among patients except for women who previously received chemotherapy, where a significantly elevated rate of spontaneous abortion was noted P < 0.05).


CONCLUSIONS
The establishment of pregnancy utilizing oocyte donation is not adversely affected by the chronological age of the recipient, inferring that the age-related decline in fertility is due primarily to oocyte aging, and not to loss of endometrial receptivity. Also, prior exposure to chemotherapy may alter endometrial integrity and lead to greater pregnancy wastage in women receiving donated embryos.
Sauer
M V
MV
Department of Obstetrics & Gynecology, University of Southern California School of Medicine, Los Angeles 90024.
Paulson
R J
RJ
Ary
B A
BA
Lobo
R A
RA
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects; D002140:California; D004334:Drug Administration Schedule; D010064:Embryo Implantation; D004958:Estradiol / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005327:Fetal Resorption / Q000453:epidemiology; D030342:Genetic Diseases, Inborn / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D016729:Leuprolide / Q000008:administration & dosage; D008423:Maternal Age; D008593:Menopause; D008596:Menotropins / Q000008:administration & dosage; D008875:Middle Aged; D018587:Oocyte Donation / Q000706:statistics & numerical data*; D010052:Ovariectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology; D011374:Progesterone / Q000008:administration & dosage; D012189:Retrospective Studies; D014495:Universities
D000970:Antineoplastic Agents; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D016729:Leuprolide