title: In vitro fertilization in women under 35: counseling should differ by age.
abstract: OBJECTIVE
  The aim of this study is to evaluate the outcomes of in vitro fertilization (IVF), including cumulative live birth rate, among women <25 years, 25 to <30 years, and 30 to <35 years.
  
  
  METHODS
  A retrospective cohort study of all women 18 to <35 years of age at their first fresh-embryo, non-donor IVF cycle from January 1995 through December 2012 at a single center was conducted. A competing-risk regression model was used to estimate the cumulative probability and 95 % confidence interval (CI) of the first live birth in up to 6 cycles during the study period with IVF cycle number as the time metric.
  
  
  RESULTS
  Among 7243 women who underwent 16,792 cycles, there were 163 (2.3 %) women <25 years, 1691 (23.3 %) women 25 to <30 years, and 5389 (74.4 %) women 30 to <35 years. Women <25 years had the lowest cumulative live birth rate after each cycle, followed by women 30 to <35 years. In both groups, the cumulative live birth rate after 6 cycles was significantly lower than that of women 25 to <30 years; these rates were 58 % (95 % CI 0.51-0.66) among women <25 years, 69 % (95 % CI 0.67-0.71) among women 25 to <30 years, and 64 % (95 % CI 0.63-0.65) among women 30 to <35 years.
  
  
  CONCLUSIONS
  Our findings are consistent with other reports of less favorable IVF treatment outcomes in women <25 years of age following their first IVF cycle. This indicates that there are underlying factors in couples with a female <25 years of age that should lead to different treatment counseling when they attempt IVF.
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.|Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.|Boston IVF, 130 2nd Avenue, Waltham, MA, 02451, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Humm
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.|Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Dodge
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.|Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.|Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.|Boston IVF, 130 2nd Avenue, Waltham, MA, 02451, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Penzias
authors.affiliation: , 2700 Highway 280 South, Suite 370 East, Birmingham, AL, 35223, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Malizia
authors.affiliation: Boston IVF, 130 2nd Avenue, Waltham, MA, 02451, USA.
authors.forename: D
authors.initials: D
authors.lastname: Sakkas
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA. mhacker@bidmc.harvard.edu.|Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. mhacker@bidmc.harvard.edu.
authors.forename: M R
authors.initials: MR
authors.lastname: Hacker
mesh_terms: D000328:Adult; D001723:Birth Rate; D015331:Cohort Studies; D003376:Counseling; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male / Q000628:therapy; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Cumulative live birth rate; IVF; In vitro fertilization; Young women