Cumulative delivery rates after ICSI in women aged >37 years.
BACKGROUND
Female patients aged >37 years have a poor prognosis after ICSI. To determine the cumulative delivery rates in these women by life-table analysis, 228 patients aged >37 years who had undergone a total of 437 ICSI cycles were analysed retrospectively.


METHODS
Only cycles in which fresh ejaculated sperm was used, and in which at least one oocyte was micro-injected, were analysed. The main outcome measure was cumulative rate of deliveries. Any delivery after 25 weeks gestation was included in the study.


RESULTS
In women aged 38-39 years, the real cumulative delivery rate after two cycles was 21%, while the expected delivery rate was 26%. In patients aged 40-43 years, the real and expected cumulative delivery rates were 12 and 17% respectively after three cycles, when they reached a plateau. There was only one delivery in the age group >43 years, which consisted of 26 patients with 66 cycles. In women aged >37 years, an expected cumulative delivery rate of 30% may be obtained at the end of the fourth cycle. Women aged >43 years do not have a realistic chance of achieving a delivery with their own oocytes.


CONCLUSIONS
This life-table analysis provides a means by which to counsel couples about their chances of achieving a delivery by ICSI at an age >37 years.
Osmanagaoglu
Kaan
K
Centre for Reproductive Medicine, Dutch-speaking Brussels Free University, Laarbeeklaan 101, B 1090 Brussels, Belgium. osmanagaoglu@hotmail.com
Tournaye
Herman
H
Kolibianakis
Efstratios
E
Camus
Michel
M
Van Steirteghem
Andre
A
Devroey
Paul
P
D000328:Adult; D000375:Aging / Q000502:physiology*; D001723:Birth Rate; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D015993:Life Tables; D008423:Maternal Age; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic