Influence of advanced age on the blastocyst development rate and pregnancy rate in assisted reproductive technology.
OBJECTIVE
To evaluate the percentage of blastocysts developing, the pregnancy rate, the implantation rate, and the abortion rate in women >40 years of age using a cell-free culture system for the development of viable human blastocysts.


METHODS
Retrospective clinical study.


METHODS
Private IVF units.


METHODS
Two hundred ninety-three cycles in patients undergoing IVF treatment for infertility. Sixty-two cycles were in patients > or =40 years of age, and 231 cycles were in patients <40 years of age.


METHODS
Pronucleate oocytes obtained from IVF were cultured in vitro for 5-6 days. One to four embryos were transferred.


METHODS
Blastocyst development rate, pregnancy rate, implantation rate, and abortion rate.


RESULTS
From 293 cycles, 3,115 pronucleate oocytes were cultured, producing 1,175 blastocysts. In the women >40 years of age, the blastocyst development rate was 22.2%, and in the younger group, the rate was 40.5%. The pregnancy rate and implantation rate in the > or =40-year age group were 21.1% and 8.9%, respectively; corresponding rates in the younger group were 44.6% and 19.9%. The abortion rate was increased for the > or =40-year age group (25% versus 13.3%).


CONCLUSIONS
Success rates for the development of viable human blastocysts, pregnancy, and implantation decline significantly in women > or =40 years old.
Pantos
K
K
Centre for Human Reproduction, Athens, Greece. pantos@iname.com
Athanasiou
V
V
Stefanidis
K
K
Stavrou
D
D
Vaxevanoglou
T
T
Chronopoulou
M
M
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000375:Aging; D001755:Blastocyst / Q000502:physiology*; D046508:Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D016896:Treatment Outcome