Fertility treatment in the forty and older woman

Purpose. To determine the outcomes and logical progression of fertility treatment in women forty Years and older using their own oocytes. Methods: This was a retrospective study in which 401 completed treatment cycles in 152 women aged forty and older were reviewed. Results: Assisted reproductive technology, (ART) cycles (n = 58) were reviewed, comprising both in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Intrauterine insemination (IUI) cycles (n = 343) were reviewed, consisting of 38 unstimulated natural cycle-IUI (NC-IUI), 194 clomiphene citrate-IUI (CC-IUI), and 111 injectable gonadotropins-IUI (INJ-IUI) cycles. The live birth rate of 15.5% for ART cycles was significantly higher than the live birth rate of 3.2% seen for all IUI cycles (P = 0.0007). There were no differences among treatment groups in spontaneous abortion, preterm delivery, or ectopic pregnancy rates. Conclusions. For women greater than or equal to40 years of age who wish to use their own eggs, ART offers the best chances for conception and delivery.