Journal of Endocrinology and Reproduction

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Female Fertility Clock Closes to Tick around the Age of 43


Affiliations
1 Department of Assisted Reproduction, Institute of Reproductive Medicine, HB-36/A/3, Sector -III, Salt Lake City, Kolkata − 700064, West Bengal, India
2 Division of Molecular Medicines, Bose Institute (Centenary Building), P 1/12, C. I. T. Road, Scheme-VIIM, Kolkata − 700054, West Bengal, India
     

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Objective: To investigate if attempting In Vitro Fertilization (IVF) in women over 40 is of worth. Materials & Methods: Two hundred and thirty nine women over 40 years of age undergoing IVF were enrolled. Long protocol was used for downregulation followed by stimulation and IVF-ET. The primary outcome measure was live-birth rate. Secondary outcomes included rates of miscarriage, cycle cancellation, obstetrical complications, and maternal and fetal adverse events. Results: Clinical pregnancy rates per cycle were 42.85 %, 39.34 %, 34.09 %, 27.27 % and 16.66 % for 40, 41, 42, 43 and 44 years old, respectively. Absolute difference in live birth rate in age 40 - 44 vs control, -15 percentage points; 95 % Confidence Interval (CI) -45 to 15.1, -18.77 percentage points; 95 % CI,(-56.31 to 18.79), -23.77 percentage points; 95 % CI,(-71.31 to 23.81), -25.82 percentage points; 95 % CI, (-77.48 to 25.84) and, - 27.72 percentage points; 95 % CI, (-83.16 to 27.76), respectively. Intra-uterine growth restriction and preterm delivery occurred significantly more frequently in the age group of 42 and above. Only one IVF cycle in patients aged 44 resulted in delivery. Conclusion: It appears that IVF treatment should be limited to patients not older than 43 years, with adequate ovarian response.

Keywords

Age, Live Birth Rate, Ovarian Function.
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  • Female Fertility Clock Closes to Tick around the Age of 43

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Authors

Baidyanath Chakravarty
Department of Assisted Reproduction, Institute of Reproductive Medicine, HB-36/A/3, Sector -III, Salt Lake City, Kolkata − 700064, West Bengal, India
Ratna Chattopadhyay
Department of Assisted Reproduction, Institute of Reproductive Medicine, HB-36/A/3, Sector -III, Salt Lake City, Kolkata − 700064, West Bengal, India
Kuladip Jana
Division of Molecular Medicines, Bose Institute (Centenary Building), P 1/12, C. I. T. Road, Scheme-VIIM, Kolkata − 700054, West Bengal, India
Pratip Chakraborty
Department of Assisted Reproduction, Institute of Reproductive Medicine, HB-36/A/3, Sector -III, Salt Lake City, Kolkata − 700064, West Bengal, India

Abstract


Objective: To investigate if attempting In Vitro Fertilization (IVF) in women over 40 is of worth. Materials & Methods: Two hundred and thirty nine women over 40 years of age undergoing IVF were enrolled. Long protocol was used for downregulation followed by stimulation and IVF-ET. The primary outcome measure was live-birth rate. Secondary outcomes included rates of miscarriage, cycle cancellation, obstetrical complications, and maternal and fetal adverse events. Results: Clinical pregnancy rates per cycle were 42.85 %, 39.34 %, 34.09 %, 27.27 % and 16.66 % for 40, 41, 42, 43 and 44 years old, respectively. Absolute difference in live birth rate in age 40 - 44 vs control, -15 percentage points; 95 % Confidence Interval (CI) -45 to 15.1, -18.77 percentage points; 95 % CI,(-56.31 to 18.79), -23.77 percentage points; 95 % CI,(-71.31 to 23.81), -25.82 percentage points; 95 % CI, (-77.48 to 25.84) and, - 27.72 percentage points; 95 % CI, (-83.16 to 27.76), respectively. Intra-uterine growth restriction and preterm delivery occurred significantly more frequently in the age group of 42 and above. Only one IVF cycle in patients aged 44 resulted in delivery. Conclusion: It appears that IVF treatment should be limited to patients not older than 43 years, with adequate ovarian response.

Keywords


Age, Live Birth Rate, Ovarian Function.

References





DOI: https://doi.org/10.18311/jer%2F2021%2F27816