Fertility treatment in the forty and older woman.
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.
Auyeung
A
A
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108-2259, USA.
Klein
M E
ME
Ratts
V S
VS
Odem
R R
RR
Williams
D B
DB
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
D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene