title: Cumulative live birth rates following IVF in 41- to 43-year-old women presenting with favourable ovarian reserve characteristics.
abstract: For women aged 41-43 years old, success rates in IVF are generally poor. This study aimed to assess cumulative live birth rate related to treatment costs over a maximum of three IVF cycles in selected women who were considered to still have adequate ovarian reserve. Fifty-five patients (38% of the total cohort, n = 144) were excluded from IVF treatment based on low antral follicle count (<5 follicles) and/or elevated basal FSH (>15 IU/l). Of those admitted, 66 (74%) actually started and completed a total of 125 IVF/intracytoplasmic sperm injection cycles. Treatment resulted in 10 live births (8% per cycle). Kaplan-Meier survival analysis revealed a realistic cumulative live birth rate after three cycles of 17%. The direct medical costs per live birth were calculated to be approximately 44,000 euro. These results show that selection towards favourable ovarian reserve status in the female age group 41-43 years yielded disappointing results in terms of cumulative live birth rates after IVF. In view of the costs raised per live birth, improvement of selection parameters for treatment in this age group is warranted.
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van Disseldorp
authors.forename: M J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: E R
authors.initials: ER
authors.lastname: Klinkert
authors.forename: E R
authors.initials: ER
authors.lastname: te Velde
authors.forename: B C
authors.initials: BC
authors.lastname: Fauser
authors.forename: F J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000328:Adult; D001723:Birth Rate; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000378:metabolism*; D006801:Humans; D050498:Live Birth; D006080:Ovarian Follicle / Q000473:pathology* / Q000502:physiology; D010053:Ovary / Q000473:pathology* / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D005640:Follicle Stimulating Hormone