The ovarian response as a predictor for successful in vitro fertilization treatment after the age of 40 years

Roest, Jan; Heusden, Arne M. van; Mous, Harold V. H.; Zeilmaker, G. H.; Verhoeff, Arie

doi:10.1016/s0015-0282(16)58691-9

Cited by 71 publications

(28 citation statements)

References 13 publications

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“…It has been reported that, women 40 years old with adequate follicular development may represent a subgroup of patients with higher chances of conception [6,18]. In one of the earlier studies reporting ART success rates in advanced age groups, Bopp et al [1] emphasized the negative effect of maternal age on GIFT and IVF outcome.…”

Section: Discussionmentioning

confidence: 99%

Reproductive outcome of women 43 years and beyond undergoing ART treatment with their own oocytes in two Connecticut university programs

Çetinkaya

Siano

Benadiva

et al. 2013

J Assist Reprod Genet

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Purpose The aim of this study was to analyze the outcomes of IVF/ICSI cycles in women aged 43 and beyond. Methods Retrospective analysis of clinical pregnancy and live birth rates in168 fresh, non donor, ART cycles performed in two Connecticut university IVF programs. Results In women of 43 and 44 years the overall clinical pregnancy and live birth rates were 8.3 % and 5.3 % per initiated cycle, respectively. There were no clinical pregnancies in women ≥45 years old. First cycle characteristics were not different from repeated cycles in terms of duration of ovulation induction, number of collected oocytes and transferred embryos (p>0.05). Conclusions Pregnancies can still be achieved with IVF/ICSI up to the age of 44. Since most pregnancies occurred within the first 3 cycles, another attempt may be a reasonable option before resorting to oocyte donation for patients who failed two previous cycles. Women 45 years and beyond do not benefit from ART procedures using their own oocytes.

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Section: Discussionmentioning

confidence: 99%

Reproductive outcome of women 43 years and beyond undergoing ART treatment with their own oocytes in two Connecticut university programs

Çetinkaya

Siano

Benadiva

et al. 2013

J Assist Reprod Genet

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“…Moreover, those reports did not provide direct information regarding the responsiveness of the ovaries to the exogenous Gn used in ovarian stimulation for ART. In fact, other studies proposed that the clinical response to Gn treatment would be a more direct way to assess ovarian reserve and a better predictor of fertility potential (Roest et al, 1996;Farhi et al, 1997;Peñar-rubia et al, 2000). Phelps et al(1998) found that the estradiol concentration measured on Day 4 of Gn therapy was highly predictive of successful ovulation induction and pregnancy outcome in GnRHa-rFSH cycles.…”

Section: Discussionmentioning

confidence: 99%

“…However, whether these indirect provocative tests are more informative of ovarian reserve than basal hormone remains controversial (Galtier-Dereure et al, 1996;Ravhon et al, 2000). Furthermore, neither basal hormonal measurements nor those dynamic tests are capable of providing direct manifestation concerning the responsiveness of the ovaries to the exogenous Gn used in ovarian stimulation for ART (Roest et al, 1996;Farhi et al, 1997;Peñarrubia et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Miao

Huang

2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (<40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration of gonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (r s =0.46~0.61, P=0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (r s =−0.67~−0.38, P=0.000 or P<0.01) with total rFSH dose and total days of rFSH stimulation. (2) No significant variation (P>0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged >35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age <35 years was found; however, IVF pregnancy outcome is significantly lower in women of age >35 years.

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“…It would be useful to investigate whether AMH or AFC could differentiate in the prognosis of women who are normally denied IVF treatment because of advanced age. Older patients with a normal response might still perform well in IVF, and AMH or AFC levels have the potential to detect such women (35). Biologically plausible ϩϩϩ ϩϩ/ϩϩϩ ϩϩ ϩϩ/ϩϩϩ ϩ Cross-sectional relation with age ( Fig.…”

Section: Figurementioning

confidence: 99%

Serum antimüllerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: A longitudinal study

Rooij

Broekmans

Scheffer

et al. 2005

Fertility and Sterility

525

295

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Objective: The aim of this study was to assess which of the basal ovarian reserve markers provides the best reflection of the changes occurring in ovarian function over time (i.e., reproductive aging). Design: Prospective longitudinal study. Setting: Healthy volunteers in an academic research center. Patient(s): Eighty-one women with normal reproductive performance during the course of their lives were longitudinally assessed. In this select group of women, becoming chronologically older was considered as a proxy variable for becoming older from a reproductive point of view. Intervention(s):The women were assessed twice, with on average a 4-year interval (T 1 and T 2 ). The number of antral follicles on ultrasound (AFC) and blood levels of antimüllerian hormone (AMH), FSH, inhibin B, and E 2 were assessed. Main Outcome Measure(s): Longitudinal changes of the markers mentioned and the consistency of these parameters over time. Result(s):The mean ages at T 1 and T 2 were 39.6 and 43.6 years, respectively. Although AFC was strongly associated with age in a cross-sectional fashion, it did not change over time. The AMH, FSH, and inhibin B levels showed a significant change over time, in contrast to E 2 levels. The AMH and AFC were highly correlated with age both at T 1 and T 2 , whereas FSH and inhibin B predominantly changed in women more than 40 years of age. To assess the consistency of these parameters over time, we investigated whether a woman's individual level above or below the mean of her age group at T 1 remained above or below the mean of her age group at T 2 . Serum AMH concentrations showed the best consistency, with AFC as second best. The FSH and inhibin B showed only modest consistency, whereas E 2 showed no consistency at all. Conclusion(s):These results indicate that serum AMH represents the best endocrine marker to assess the age-related decline of reproductive capacity. (Fertil Steril 2005;83:979 -87.

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The ovarian response as a predictor for successful in vitro fertilization treatment after the age of 40 years

Cited by 71 publications

References 13 publications

Reproductive outcome of women 43 years and beyond undergoing ART treatment with their own oocytes in two Connecticut university programs

Reproductive outcome of women 43 years and beyond undergoing ART treatment with their own oocytes in two Connecticut university programs

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Serum antimüllerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: A longitudinal study

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