Analysis of 2,386 consecutive cycles of in vitro fertilization or intracytoplasmic sperm injection using autologous oocytes in women aged 40 years and above.
OBJECTIVE
To estimate the live-birth and miscarriage rates in 1-year age increments for women aged ≥40 years undergoing in vitro fertilization or intracytoplasmic sperm injection (ICSI-IVF) with autologous oocytes.


METHODS
Retrospective database and chart analysis.


METHODS
Egyptian IVF and embryo transfer center.


METHODS
One thousand six hundred forty-five women aged ≥40 years undergoing 2004 fresh nondonor IVF-ICSI cycles.


METHODS
ICSI-IVF using ejaculate or surgically retrieved sperm.


METHODS
Pregnancy and live-birth rates per initiated cycle based on 1-year age increments.


RESULTS
The overall live-birth rate per initiated cycle was 6.7% (range: 10% to 0.5%). The pregnancy loss rate was 44.8% (range: 39.0% to 75.0%). The cutoff age was 43 years, when the pregnancy rate became statistically significantly lower. The live-birth rate per initiated cycle was statistically significantly higher for women <43 years old, 132 out of 1766 (7.4%) compared with women ≥43 years old, 7 out of 620 (1.1%). The miscarriage rate was 127 out of 295 (43.1%) compared with 15 out of 23 (65.2%) for the two age groups, respectively.


CONCLUSIONS
The success rate of ICSI-IVF as measured by live-birth rate per initiated cycle was statistically significantly higher for women aged <43 years as compared with women aged ≥43 years. Once women have attained age 43 years, alternative methods such as oocyte donation cycles or previously cryopreserved embryos are likely to be more effective.
Serour
Gamal
G
Al Azhar University, Cairo, Egypt.
Mansour
Ragaa
R
Serour
Ahmed
A
Aboulghar
Mona
M
Amin
Yahia
Y
Kamal
Omnia
O
Al-Inany
Hesham
H
Aboulghar
Mohamed
M
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D004534:Egypt; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018587:Oocyte Donation; D054315:Oocyte Retrieval; D009865:Oocytes; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D016896:Treatment Outcome