In-vitro fertilisation in women aged 40 years and above.
BACKGROUND
To compare the results of in-vitro fertilisation (IVF) in women aged less than 40 years with those aged 40 years and above with baseline follicle-stimulating hormone (FSH) levels less than 15iu and using their own oocytes.


METHODS
A total of 2179 fresh IVF cycles were started in KK Women's and Children's Hospital IVF Centre from 1997 to 2002, of which 247 cycles were done in women 40 to 45 years with FSH levels less than 15iu. The remaining 1932 cycles were performed in another group of women aged less than 40 years old. All couples were treated using our hospital's IVF protocol, and the same clinical and embryological team was involved in all treatments. The medical records of patient outcomes were retrospectively reviewed. The main outcomes measured were clinical pregnancy, miscarriage and delivery rates.


RESULTS
The total number of fresh cycles performed in women over 40 years was 247 cycles. Of these, 186 (75.3 percent) cycles reached oocyte collection, and 179 (72.5 percent) cycles reached embryo transfer. The total number of pregnancies was 22 (12.3 percent). The number of cancelled cycles was 61 (24.7 percent). Women less than 40 years of age demonstrated higher rates in cycles reaching oocyte collection (89.2 percent), embryo transfer (84.6 percent), pregnancy rates (32.9 percent) and live-birth rates (24.0 percent). They also reported a lower miscarriage (36.1 percent) and cancellation rate (10.9 percent) as compared to the group of older women.


CONCLUSIONS
As older women seek IVF treatment, it is necessary for them to understand that chances of pregnancy decrease with increasing age. Our results show that as women exceed 40 years old, pregnancy and live-birth rates fall with concurrent rising miscarriage and cycle cancellation rates.
Seng
S W
SW
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. seng.shay.way@kkh.com.sg
Yeong
C T
CT
Loh
S F
SF
Sadhana
N
N
Loh
S K E
SK
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005640:Follicle Stimulating Hormone / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010062:Ovulation Induction; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
D005640:Follicle Stimulating Hormone