title: National survey of the current management of infertility in women aged 40 and over in the UK.
abstract: We conducted a national survey to identify the variation in the management of infertility in women aged 40 and over among the assisted conception units in the UK. A total of 44 out of 69 IVF units replied by filling in a questionnaire. Nearly half of the units (49%) offer treatment to this age group 6 months after trying for a pregnancy. As first-line management, 71.7% would offer conventional in vitro fertilisation (IVF) and 17.9% intrauterine insemination (IUI). On average, the doctors would move on from IUI to the next step after three attempts. The survey revealed a mean age of 45 as the upper limit for application of IVF (own eggs), and 43% of the units will recommend three cycles of IVF using own eggs before moving to egg donation. Among interventions to improve outcome, 33.3% would consider blastocyst transfer, 5.9% pre-implantation genetic screening (PGS) and 3.9% assisted zona hatching (AZH).
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK. g_marinakis@yahoo.co.uk
authors.forename: G
authors.initials: G
authors.lastname: Marinakis
authors.forename: D
authors.initials: D
authors.lastname: Nikolaou
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D019538:Health Care Surveys; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom