Oocyte donation was carried out in 87 patients in 141 replacement cycles. These patients received oocytes from 108 women undergoing assisted reproductive technology procedures at our centre. Standardized hormonal replacement therapy and in-vitro fertilization procedures were performed. We divided recipients into four groups according to their age (group A, 21-35 years; B, 36-40 years; C, 41-49 years; and D, 50-61 years). Oocytes donors were 21-35 years old, and equally spread across these different age groups. There were significant differences in the pregnancy and implantation rates according to the age of the recipients; which were 45% and 23% respectively in women 21-35 years old (group A) versus 23% and 10% in women 41-49 years old (group C). A comparison of data between oocyte donors and young recipients, with similar results in donors and young recipients, with pregnancy rates of 45% and 42% and implantation rates of 23% and 19.5% respectively. Statistically significant differences were found between donors and the older recipients, pregnancy rates being 43% versus 23%, and implantation rates 18% versus 10%. These data seem to demonstrate a lesser likelihood of pregnancy and implantation in older recipients because of increasing uterine age.
Endometrial receptivity is tolerant to a wide duration of E2 treatment (until 2 months), while waiting for oocytes available for donation, but best results are achieved with a treatment range of 11 to about 40 days.
Intracytoplasmic sperm injection was carried out in 15 oocyte donation cycles of 15 infertile couples where oocytes had failed to fertilize after in-vitro fertilization (IVF) procedures or where the male partner had severe male factor infertility. A total of 62 oocytes were donated, but only 46 of these, in metaphase II, were injected. Of the injected oocytes, 31 (67.3%) had two pronuclei the morning after the injection procedure. On the following day, 29 embryos were obtained (93% of the fertilized oocytes) and 25 were transferred. Two patients were not successful and consequently did not undergo embryo transfer. A total of five clinical pregnancies were obtained, giving pregnancy rates of 33.3 and 38.4% per started cycle and embryo transfer respectively.
An oocyte donation programme was carried out in 122 patients aged between 40 and 49 years for a total of 225 replacement cycles. Eggs were donated by 103 women undergoing assisted reproduction technologies in our infertility centre. Recipients were divided into different groups according to whether they were menopausal (group A) or cyclic and treated with short- (group B) or long-term (group C) gonadotrophin-releasing hormone analogues. In group C, the ovarian suppression of the patients was prolonged with the aim of producing a type of artificial menopause. Oocyte donors were aged between 21 and 35 years, and were equally distributed between the different groups. There were significant differences in pregnancy and implantation rates according to ovarian status: 30.8 and 16.1% respectively in group A, 30.6 and 17.7% respectively in group C versus 10.4 and 5.6% respectively in group B. Apart from improved pregnancy and implantation rates in cyclic women aged > 40 years after long-term down-regulation, these data seem to demonstrate an important role for the endometrium in the implantation process.
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