title: One thousand initiated cycles of in vitro fertilization in women > or = 40 years of age.
abstract: OBJECTIVE
  To evaluate the results of IVF in women > or = 40 years of age using their own oocytes.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Wolfson and Royal Masonic in vitro fertilization units, London, United Kingdom.
  
  
  METHODS
  A total of 1,087 IVF cycles were started in women > or = 40 years of age.
  
  
  METHODS
  Medical records of patient outcomes were reviewed.
  
  
  METHODS
  Clinical pregnancy, miscarriage, and delivery rates.
  
  
  RESULTS
  Of the 1,087 cycles started in 471 women > or = 40 years of age, 842 reached oocyte retrieval (77.5%) and 702 had embryos transferred (64.6%). The pregnancy rate (PR) was significantly lower in women > or = 40 years of age than in a control group of women <40 years of age (11.3% versus 28.2%). It decreased sharply in women >42 years of age, and no women >45 years of age had a child. Women > or = 40 years of age were more likely to miscarry (27% versus 12.7%). When only one embryo was available for transfer, the PR was 3.3%. When >2 embryos were available for transfer, the PR was similar whether 2 or 3 embryos were replaced. No triplet pregnancy occurred. Women > or = 40 years of age achieved a cumulative PR of 30% after three cycles with a cumulative "take home baby" rate of 21%.
  
  
  CONCLUSIONS
  In vitro fertilization is a reasonable treatment for women <45 years of age using their own gametes. Those with a "good response" in their first attempt may be encouraged to complete three cycles with an acceptable chance of conception.
authors.affiliation: Institute of Obstetrics and Gynecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom. amir.lass.gb_cb01@serono.com
authors.forename: A
authors.initials: A
authors.lastname: Lass
authors.forename: C
authors.initials: C
authors.lastname: Croucher
authors.forename: S
authors.initials: S
authors.lastname: Duffy
authors.forename: K
authors.initials: K
authors.lastname: Dawson
authors.forename: R
authors.initials: R
authors.lastname: Margara
authors.forename: R M
authors.initials: RM
authors.lastname: Winston
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008423:Maternal Age; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies