In vitro fertilization in women over 40 years of age. A study on retrospective data for eight years

A retrospective (1987-1995), single-center study was conducted to evaluate the IVF success rate in women who were 40 years and over. Controls were randomly selected patients who were 35 years or younger from the same center. The main evaluation criterion was the number of pregnancies initiated in each group and especially the number of full-term deliveries (take-home baby rate). Differences were considered as statistically significant for P less than or equal to 0.05. A total of 194 IVF attempts in women 40 years or over were compared to 209 attempts in the control group. The mean ages of the two groups was 40.9 vs. 29.3 years (P<0.001). The duration of follicle stimulation was 12.9 vs. 13.1 days (not significant, NS). The number of ampules was 29.6 vs. 29.2 (NS). Serum estradiol levels were 1435.8 vs. 2020.8 pg/ml (P<0.001). Oocytes: 4.6 vs. 7.3 (P<0.001). Embryos: 1.7 vs. 2.8 (P<0.0001). Full-term deliveries: 3.6 vs. 13.4% (P<0.05). Better oocyte retrieval was achieved (5.3 vs. 3.3; P=0.001) in the group that was 40 years or over, but there were no differences in the rate of embryo transfer (1.9 vs. 1.3; NS) and full-term deliveries (4.2 vs. 2.9%) in a long protocol compared to a short one. The results of the study are similar to those found in the literature. Indications for standard IVF without oocyte donation should be carefully thought out and couples should be warned of the low success rate. (C) 1998 Elsevier Science Ireland Ltd.