RETIRED: Advanced Reproductive Age and Fertility

Cheung, Anthony P.; Sierra, Sony; AlAsiri, Saleh; Carranza-Mamane, Belina; Case, Allison; Dwyer, CM; Graham, James R.; Havelock, Jon; Hemmings, Robert; Lee, Francis; Liu, Kimberly; Murdock, Ward; Senikas, Vyta; Vause, Tannys; Wong, Benjamin

doi:10.1016/s1701-2163(16)35087-3

Cited by 193 publications

(143 citation statements)

References 78 publications

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“…We found that first of all, in our study, the fertility significantly dropped in women over 30 years old, which is earlier than some other reports of the late 30s [11]. In our study, in women of 31-35 age period undergoing IVF, the mean starting dose of Gn and mean total dose of Gnin each cycle were significantly higher than those in women of 21-30 age period, while the mean retrieved oocyte number was significantly lower.…”

Section: Discussionsupporting

confidence: 51%

“…Some IVF centers even limited the last age for IVF as 43 years old [8]. Women with advanced maternal age will have poor ovary response during controlled ovary hyperstimulation (COH), low retrieved oocyte number, lowoocyte fertilization rate, low good quality embryo rate, low embryo implantation rate, low pregancy rate, high miscarriage rate, high preterm delivery rate and high birth defect rate [6,[9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

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Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET)

Yan

Tang

et al. 2012

Sci. China Life Sci.

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This is a retrospective, observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). 11830 IVF-ET cycles from 10268 women were included. Four groups of different maternal age periods were compared. The groups were 2130 years old group (4549 cycles), 31-35 years old group (4424 cycles), 36-40 years old group (2429 cycles), and over 40 years old group (428 cycles). The mean starting dose of Gn and mean total dose of Gn in each cycle were significantly higher (P<0.01), while the mean retrieved oocyte number was significantly lower (P<0.01) in groups of higher maternal age period than those in each of the lower groups. The biochemical pregnancy rate and the clinical pregnancy rate were significantly lower (P<0.01), while the miscarriage rate was significantly higher (P<0.01) in groups of higher maternal age period than those in the lower groups. No difference was found in two-pronuclear zygotes (2PN) rate and good quality embryo rate among different groups. Birth defect rate was also comparable in the born babies in different groups. In the group with patients' age over 40 years old, the pregnancy rate was 26.87%, the clinical pregnancy rate was 19.39%, while the miscarriage rate after clinical pregnancy was 36.14%. To draw the conclusion, patients with higher maternal age had worse IVF outcomes. In women of fertile age, patients between 20 and 30 years old have the best IVF outcomes. Patients over 40 years old have poor IVF outcome and high miscarriage rate, which suggested the necessity of preimplantation genetic screening (PGS).in vitro fertilization, outcome, pregnancy rate, miscarriage rate, birth defect, maternal age Citation:Yan J H, Wu K L, Tang R, et al. Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Sci China Life Sci, 2012, 55: 694 -698,

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET)

Yan

Tang

et al. 2012

Sci. China Life Sci.

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“…In our study, 29 (35.4%) patients presenting with primary and 11 (61.1%) patients with secondary infertility were of age > 35 years. Because of the decline in fertility and the increased time to conception that occurs after the age of 35, women > 35 years of age should be referred for infertility work-up after 6 months of trying to conceive (16). The duration of infertility was 1-5 years in the majority of patients (50%) in primary and (55.5%) in secondary infertility.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley

Ain¹,

Ara²,

Ahmad³

et al. 2014

IJWHR

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Objectives: To evaluate the female factors in infertility using laparoscopy in Kashmiri women. Materials and Methods: One hundred cases of infertility [primary and secondary] were included in this prospective study. Before the procedure, apart from complete history and detailed examination, baseline investigations (complete blood count, blood sugar, kidney and liver function tests, ECG, chest X-ray) were performed as per our institutional protocol for pre-anaesthesia check up. Laparoscopy was done in proliferative phase of menstrual cycle. To test the patency of tubes, chromotubation was done in all cases under laparoscopic vision by using 10-15 ml of autoclaved methylene blue dye. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results. Results: In primary infertility group [n=82], most common laparoscopic finding was tubal occlusion in 15 (18.3%), followed by endometriotic deposits in 14 (17.1%) patients. Other findings were polycystic ovaries in 10 patients (12.2%), peritubal and periovarian adhesions in 6 patients (7.3%), fibroids in 6 patients (7.3%), genital tract tuberculosis in 5 patients (6.1%), ovarian cysts in 4 patients (4.8%), hypoplastic uterus in 2 patients (2.4%) and pelvic inflammatory diseases in 2 patients (2.4%), in this group. The commonest finding by laparoscopy in patients with secondary infertility [n=18] was tubal occlusion in 5 (27.7%), followed by peritubal and periovarian adhesions in 4 (22.2%) patients. Conclusion: laparoscopy is very effective and cheap method in evaluating infertile women and should be considered earlier in infertility workup for effective and early treatment decisions.

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“…In women aged 41-42, the pregnancy rate per cycle was 4.3 %, dropping to 1 % for women aged above 42 [29]. In summary, recent literature renders clomiphene citrate of little or no value to older women seeking infertility treatment, and swift referral for IVF should be sought after 1 or 2 failed cycles [30].…”

Section: Ovulation Induction With Clomiphene Citrate and Intrauterinementioning

confidence: 97%

What is the best treatment option for infertile women aged 40 and over?

Armstrong

Akande

2013

J Assist Reprod Genet

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Purpose To summarise the causes of decreased fecundity with age and review chronological vs biological ovarian ageing. To explore the clinician's means of assessing a woman's ovarian reserve. To review the recent literature on the effectiveness of different assisted reproductive technology (ART) techniques for women aged 40 and over and offer a single best treatment option. Methods Pubmed and google scholar were searched for relevant articles using key words. Data were extracted based on authors, year, aims, sample and results. Results Success rates for women aged 40 or over with clomiphene, IUI, IUI with FSH are all extremely low, at less than 1 % live birth per cycle. However, IVF offers a success rate of around 13.7 % per cycle. Conclusion An exploration of the effectiveness of available treatment options for older infertile women using their own gametes suggests that IVF offers the best prospects of success. Attempting treatments other than IVF will delay conception unnecessarily.

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RETIRED: Advanced Reproductive Age and Fertility

Cited by 193 publications

References 78 publications

Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET)

Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET)

Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley

What is the best treatment option for infertile women aged 40 and over?

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