No abstract

Purpose To determine if IVM of oocytes from unstimulated cycle is a treatment option for patients who did not deliver after standard IVF-ET. Method Twenty three women with PCO, thirteen of them with normal cycles and all <35 years old, who failed IVF served as their own control. During the control IVF cycle patients were stimulated with 1730.7±639.5 IU recombinant FSH, a long Buserelin acetate protocol was used and embryo transfer was performed on day 2 or 3 after ICSI. After failed IVF immature oocytes were aspirated transvaginally from antral follicles during spontaneous menstrual cycle. Embryo transfer was performed 2 or 3 days later. Result 11.4±4.8 mature oocytes and 6.7±3.2 embryos were produced with IVF, which served as the control, compared to 9.7±4.5 mature oocytes and 6.2±3.2 embryos with IVM. There was one clinical pregnancy in the IVF group which did not result in a live birth where as five singleton and one pair of twins with healthy live births and one miscarriage in the IVM group. Conclusion IVM does not involve ovarian stimulation with possible financial and health consequences. İt may be an useful treatment after unsuccessful IVF.

Amaç: Bu çalışmada 39 yaş ve üzeri infertil kadın hastalarda yaşın, prognostik faktörler ile üreme potansiyeli üzerindeki sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: İleri yaşta (≥39 yıl) 107 infertil kadın hasta retrospektif olarak değerlendirildi. Hastaların insan koryonik gonadotropin (hCG) uygulanan günde ölçülen endometrium kalınlığı, toplam kullanılan gonadotropin dozu, stimülasyon süreleri, 3. gün bazal follikül stimüle edici hormon (FSH) ile bazal estradiol (E 2 ) düzeyleri, toplanan oosit ile fertilize oosit sayıları ve transfer edilen embriyo sayıları kaydedildi. Bu parametrelerin gebelik başarısı üzerine etkileri değerlendirildi. Hastalar 39 yaş (n=47), 40-41 yaş (n=37) ve 42 ve üzeri yaş (n=23) olmak üzere üç yaş grubu karşılaştırıldı. Bulgular: Canlı doğum oranı 39 yaş grubunda %23,2 ve 40-41 yaş grubunda %14,7 olarak gözlendi. Kırk iki ve üzeri yaş grubunda ise canlı doğum görülmedi. Bu çalışmanın sonuçları yaşın, toplanan oosit ve fertilize oosit sayısının gebelik gelişimi üzerine etkisinin olduğunu gösterdi. Sonuç: Gebelik oranı 39 yaşından sonra hızlı bir şekilde düşmektedir; intrasitoplazmik sperm enjeksiyonu sonrası, hastalarda 39 yaşından itibaren gebelik başarısı 3 yıl sonra 9 kat azalmıştır. İleri maternal yaşın, gebelik ve canlı doğum oranları üzerindeki olumsuz etkisi klinik çalışmamızda da gözlenmiştir. J Turk Soc Obstet Gynecol 2014;2:78-83 Anahtar Kelimeler: Kadın, yaş, gebelik oranı Objective: The objective of this study is to investigate the effect of age on the prognostic factors and fertilization potential of infertile women who are 39 years or older. Material and Methods: 107 patients with advanced maternal age (≥39 years) were included in this retrospective study. The endometrial thickness on the day of human chorionic gonadotropin (hCG), total dose of gonadotropin used, duration of stimulation, levels of day-3 basal follicule stimulating hormone (FSH) and basal estradiol (E 2 ), number of retrieved oocytes and fertilized oocytes, and number of embryos transferred were recorded. These parameters were used to evaluate their effects on the success of pregnancy. Patients were categorized into three age groups: 39 years old (n=47), 40-41 years old (n=37), and ≥ 42 years old (n=23) and age groups were compared. Results: The rate of live birth was %23.2 in 39 years and %14.7 in 40-41 years. No live birth in 42 years or older patients was recorded. The results revealed that that the age, number of retrieved oocytes and fertilized oocytes predict the success rate of pregnancy. Conclusion: Pregnancy rate dramatically decreased after the age of 39; the success of pregnancy after the intracytoplasmic sperm injection decreases 9 times, three years later starting age of 39. The negative effect of advanced maternal age on pregnancy and live birth rates was observed in our clinical study, as well. J Turk Soc Obstet Gynecol 2014;2:78-83