title: Treatment and preservation at the extremes of reproductive age: a case report outlining the ethical dilemmas.
abstract: OBJECTIVE
  The purpose of the study was to report a livebirth from a cryopreserved embryo created from autologous oocytes collected at 47 years and 9 months that outlines the ethical difficulties of decision-making at the extreme of reproductive age.
  
  
  METHODS
  The method used was IVF and embryo cryopreservation within an assisted conception unit prior to adjuvant cancer treatment in a nulliparous patient diagnosed with breast carcinoma (47 years and 9 months at oocyte collection).
  
  
  RESULTS
  A 47-year-old nulliparous woman was diagnosed with breast malignancy during work-up for fertility treatment. Ovarian stimulation yielded one embryo from four oocytes that was cryopreserved to allow completion of adjuvant treatment. Subsequent embryo transfer cycle led to a live birth of a healthy baby girl at term, weighing 3.37 kg.
  
  
  CONCLUSIONS
  This paper demonstrates the oldest reported age of autologous oocyte collection to have achieved a livebirth. In women where most would consider treatment futile, we highlight the difficulties in decision-making in this group of patients.
authors: Lister Fertility Clinic, Lister Hospital, Chelsea Bridge Rd, London, SW1W 8RH, UK. jamesn@lfclinic.com.
authors: James D M
authors: JD
authors: Nicopoullos
authors: Lister Fertility Clinic, Lister Hospital, Chelsea Bridge Rd, London, SW1W 8RH, UK.
authors: Marie
authors: M
authors: Wren
authors: Lister Fertility Clinic, Lister Hospital, Chelsea Bridge Rd, London, SW1W 8RH, UK.
authors: Hossam
authors: H
authors: Abdalla
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D059247:Fertility Preservation; D005307:Fertilization in Vitro / Q000941:ethics* / Q000379:methods*; D006801:Humans; D008423:Maternal Age; D008875:Middle Aged; D054315:Oocyte Retrieval / Q000941:ethics / Q000379:methods; D011247:Pregnancy
keywords: Advanced maternal age; Autologous oocytes; Fertility preservation; Frozen transfer