IVF success declines sharply after age 42; IUI rates hold until age 39: fertility treatments

IVF success declines sharply after age 42; IUI rates hold until age 39: fertility treatments – Obstetrics

Kate Johnson

SAN ANTONIO — Although women between the ages of 40 and 42 can expect reduced, but reasonable, in vitro fertilization success rates, a new study suggests that those success rates plummet once they reach age 43.

“We all know that after age 40, IVF success rates drop significantly, but I wanted to see at what age specifically there is a really sharp drop,” said Dr. Selen Hotamisligil, who presented her study as a poster at the annual meeting of the American Society for Reproductive Medicine.

She said her findings indicate that IVF patients who are 43 years old should be strongly counseled about using donor eggs. Dr. Hotamisligil evaluated 799 women aged 40-45 who initiated IVF cycles at the Reproductive Science Center then in Waltham, Mass., now located in Lexington, Mass.

The patient’s age at treatment; the number of oocytes retrieved, inseminated, and fertilized; the number of embryos transferred; the number of sacs; and the pregnancy outcome all were analyzed.

All women were considered “good” candidates for IVF based on FSH levels and regular menstruation, she said.

However, the live birth rate per cycle was dramatically reduced in women aged 43 and older.

“The live birth rate for this age-group is very low, only 2.8% compared with 12% in the 42-year-olds, 15% in the 41-year-olds, and 21% in the 40-year-olds,” she said in an interview.

In a separate poster, researchers from Poissy-Saint Germain Hospital in Poissy, France, reported that intrauterine insemination (IUI) success rates are still reasonable in women aged 38 and 39 years.

“Some authors consider an age of 38 years or older to be an indication to begin IVF,” wrote Dr. Robert Wainer, the study’s lead author.

However, the study found similar IUI success rates in this age group (15.1%), compared with a previous series of 2,235 cycles in younger women (13.11%).

The researchers analyzed IUI parameters over 192 cycles in 82 patients aged 38 and 39.

Nearly half of the couples (48%) had primary infertility, for a mean duration of 4.3 [+ or -] 3.3 years. The indications for IUI were cervical (16%), male factor (37%), mixed (2%), and unexplained (45%).

On average, the couples completed 2.33 [+ or -] 1.36 IUI cycles in less than 6 months. There were 29 clinical pregnancies in the group, for an ongoing pregnancy rate per cycle of 15.1%, and 35.37% per couple.

COPYRIGHT 2004 International Medical News Group

COPYRIGHT 2004 Gale Group