Consecutive cycles in in vitro fertilization--embryo transfer.
BACKGROUND
The decline of female fertility with advancing age is well documented. The aim of this study was to compare the ovarian performance after repeated ovarian stimulation cycles in women of different ages.


METHODS
Four hundred patients who started at least three in vitro fertilization (IVF) cycles during the 5-year period between 1998 and 2002 were identified. The patients were divided into four groups: the 25-30 age group (n = 90), the 31-35 age group (n = 150), the 36-40 age group (n = 110) and the 41-45 age group (n = 50).


RESULTS
Comparing subsequent cycles versus the first treatment cycle we found a statistically significantly increased number of ampules of recombinant follicle stimulating hormone (rFSH) needed to reach follicles maturation (p < 0.001). The number of ampules of gonadotropin required was significantly higher (p < 0.001) in the groups of advanced age compared with the groups of young women. For women in the 36-40 group and in the 41-45 group we found the number of follicles, the number of oocytes and the proportion of grade A embryos, in every cycle, were significantly lower than in the groups of young women. We compared the characteristics of ovarian stimulation and response of a single age group in different consecutive cycles. We found significant differences (p < 0.05) only in the number of ampules required.


CONCLUSIONS
Maternal age adversely affected ovarian performance. During repeated IVF cycles we also noted an age-independent decline of ovarian response.
Doldi
Nicola
N
IVF Unit, Department of Obstetrics and Gynecology, Vita-Salute University, Milan, Italy. doldi.nicola@hsr.it
Persico
Paola
P
De Santis
Lucia
L
Rabellotti
Elisa
E
Papaleo
Enrico
E
Ferrari
Augusto
A
D000328:Adult; D000375:Aging; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D010062:Ovulation Induction; D011247:Pregnancy; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone