title: Fertility treatment in the forty and older woman.
abstract: OBJECTIVE
  To determine the outcomes and logical progression of fertility treatment in women forty years and older using their own oocytes.
  
  
  METHODS
  This was a retrospective study in which 401 completed treatment cycles in 152 women aged forty and older were reviewed.
  
  
  RESULTS
  Assisted reproductive technology (ART) cycles (n = 58) were reviewed, comprising both in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Intrauterine insemination (IUI) cycles (n = 343) were reviewed, consisting of 38 unstimulated natural cycle-IUI (NC-IUI), 194 clomiphene citrate-IUI (CC-IUI), and 111 injectable gonadotropins-IUI (INJ-IUI) cycles. The live birth rate of 15.5% for ART cycles was significantly higher than the live birth rate of 3.2% seen for all IUI cycles (p = 0.0007). There were no differences among treatment groups in spontaneous abortion, preterm delivery, or ectopic pregnancy rates.
  
  
  CONCLUSIONS
  For women > or = 40 years of age who wish to use their own eggs, ART offers the best chances for conception and delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108-2259, USA.
authors.forename: A
authors.initials: A
authors.lastname: Auyeung
authors.forename: M E
authors.initials: ME
authors.lastname: Klein
authors.forename: V S
authors.initials: VS
authors.lastname: Ratts
authors.forename: R R
authors.initials: RR
authors.lastname: Odem
authors.forename: D B
authors.initials: DB
authors.lastname: Williams
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology* / Q000627:therapeutic use; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D006062:Gonadotropins / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene