title: Reproductive efficiency of women over the age of 40 and the low risk of multiple pregnancies.
abstract: Infertile patients over the age of 40 are generally considered to have a low chance of success with assisted cycles despite high numbers of embryos transferred. The risk of multiple pregnancy in this group of patients is not well established. The present study determined the rate of embryos that fail to produce a live birth and the rate of multiple pregnancies in a cohort of women over the age of 40 undergoing IVF/intracytoplasmic sperm injection cycles, utilizing Society for Assisted Reproductive Technology reported cycle outcomes from national summaries as well as from two university-based IVF centres. The rate of embryo wastage for women over the age of 40 is approximately 95% and these women have a correspondingly low rate of multiple pregnancy per cycle started (2.5% and 1.6% for women aged 41-42 years and 43-44 years, respectively). These data underscore the low reproductive efficiency of oocytes in women over the age of 40 and the very low probability of a multiple-gestation live birth despite the high number of embryos transferred. This information is an important additional counselling tool at the time of embryo transfer in this group of patients.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Bromer
authors.forename: Denny
authors.initials: D
authors.lastname: Sakkas
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Siano
authors.forename: Claudio A
authors.initials: CA
authors.lastname: Benadiva
authors.forename: Pasquale
authors.initials: P
authors.lastname: Patrizio
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008423:Maternal Age; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome