Gunnala V, et al. - Researchers planned this study to assess IVF outcomes in women 45 years and older using autologous oocytes. In women aged 45 with acceptable ovarian reserve, autologous IVF was not futile but seemed to carry very low prognosis. They recommended counselling patients aged 46 and older appropriately that a live birth seems highly unlikely.

Methods

• From January 1995 to June 2015, researchers performed a retrospective cohort study reviewing all IVF cycles in women ≥ 45 years old that were conducted at one academic medical center.
• Inclusion criteria was met by 1,078 fresh, autologous IVF cycles.
• They excluded PGD/S, natural IVF, and donor egg cycles.
• Analysis of outcomes was performed for the different age groups (age 45, n = 773; age 46, n = 221; age 47, n = 57; age 48, n = 22; age 49, n = 5).
• IVF cycle characteristics, total pregnancy loss, clinical pregnancy, and live birth rates were assessed as primary outcome measures.
• They stratified these outcomes in accordance to patient age

Results

• In the study cohort, mean age of patients was 45.4 ± 0.72.
• Due to an elevated FSH or cyst, 11.7% of patients did not start and there were 28.5% of patients who were canceled prior to oocyte retrieval.
• Researchers observed an overall pregnancy rate per transfer of 18.7% (117/626); 82.1% of these ended in a pregnancy loss.
• The overall clinical pregnancy and live birth rates per transfer were 9.6 and 3.4%, respectively; the age groups were similar regarding this outcome.
• Per cycle start, women aged 45 vs women aged 46 and 47 had significantly higher positive pregnancy rates (14.1 vs. 8.6 vs. 5.9%, p = 0.04).
• They noticed live birth rate of 2.9% per cycle start and of 4.4% per embryo transfer for women 45 years old.
• Twenty one live births were observed; 20 were in women aged 45 and one live birth was in a 46-year-old woman.
• No live births were observed in any patient with ≤ 4 oocytes retrieved.