title: Female ageing and reproductive outcome in assisted reproduction cycles.
abstract: BACKGROUND
  Fertility in women declines with increasing age. With the deferment of marriage and childbearing, couples are turning to assisted reproductive technology to counteract this decline. We aimed to evaluate the results of in vitrofertilisation (IVF)/intracytoplasmic sperm injection (ICSI) in women of different age groups, and highlight the cost-effectiveness of IVF treatment in these groups while assessing its implications on the national healthcare provision model.
  
  
  METHODS
  Retrospective analysis of 3,412 stimulated IVF/ICSI cycles in a hospital-based IVF centre was performed from January 2008 to December 2010. Patients were stratified into seven age groups: < 30 years; 30-35 years; 36-37 years; 38 years; 39 years; 40-44 years; and ≥ 45 years.
  
  
  RESULTS
  Age had a significant effect on the number of cycles leading to embryo transfer (p < 0.001). The number of oocytes retrieved decreased across the various age groups (p < 0.001) and was the highest among women aged < 30 (mean 18.5 ± 10.3) years. With increasing age, there was a trend toward a lower fertilisation rate. Age also had a significant effect on the rates of clinical pregnancy, live birth and multiple pregnancies (p < 0.001).
  
  
  CONCLUSIONS
  Patients aged < 30 years had the best IVF outcomes, reflecting optimal reproductive capacity. Age-related decline in fertility starts after 30 years. Women opting for IVF should be counselled about age-specific success rates while taking into account individual risk factors.
authors.forename: T Y
authors.initials: TY
authors.lastname: Tan
authors.affiliation: Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. matthew.lau.sk@kkh.com.sg.
authors.forename: S K
authors.initials: SK
authors.lastname: Lau
authors.forename: S F
authors.initials: SF
authors.lastname: Loh
authors.forename: H H
authors.initials: HH
authors.lastname: Tan
mesh_terms: D000328:Adult; D000375:Aging; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012846:Singapore; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome