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IVF Treatment not Successful in Women 45 and Older
Women who want to be moms someday, listen up. A recent study concluded that women 45 and older do not benefit from IVF using their own eggs.
Dr. Pasquale Patrizio is an investigator in the study which analyzed the outcomes of IVF/ICSI cycles in women aged 43 and beyond. In women ages 43 and 44 the clinical pregnancy rate was 8.3 percent and the live birth rate was 5.3 %. There were no clinical pregnancies in women 45 or older.
Patrizio is the Director of the IVF Program and Director of the Fertility Preservation Program at Yale Fertility, answered questions related to the study.
Question. You looked at 168 fresh, non-donor cycles. In women 43 and 44 years old, the live birth rate was 5.3%. Were contributing factors other than age taken into account? Can you base this solely on age?
Answer. In addition to age as the sole factor of infertility, there were 36% of cycles where male factor infertility was present. These cases had a live birth rate of 7.8% while cases with exclusive decreased ovarian response had 7.2%. In other words there was no difference with ICSI since the fertilization rate between the two groups was similar.
An important point of this study is that all patients were women 43 years or older that were found to be eligible for being offered a stimulation cycle. Women who did not respond to ovarian stimulation were canceled and likewise women with baseline high FSH values or antral follicle count less than 3 did not even begin the ovarian stimulation. The point of our paper is to report the outcome of women 43 and older that “qualify” for undergoing ART cycles and still had very dismal outcomes.
Q. Your study concludes that women might benefit from a third IVF cycle if the first two cycles are not successful. Can you explain why it might take multiple cycles to have success?
A. It is not every month that a cycle produces an egg or embryo competent to result in a pregnancy and live birth. Actually, with aging, the number of months per year that women will produce a competent egg decreases.
Q. You also conclude that women 45 and older do not benefit from IVF with their own eggs. Can you provide some insight and advice to women in that age group regarding this?
A. We did not have live births in women at or above 45 years of age, independent of all other parameters. Thus chronological age alone (and thus an egg quality factor alone) determines no chance of pregnancy at these ages.
Women that are in a situation where fertility has to be postponed should consider egg freezing to preserve their future fertility chances.