BACKGROUND: Female patients aged >37 years have a poor prognosis after ICSI. To determine the cumulative delivery rates in these women by life-table analysis, 228 patients aged >37 years who had undergone a total of 437 ICSI cycles were analysed retrospectively. METHODS: Only cycles in which fresh ejaculated sperm was used, and in which at least one oocyte was micro-injected, were analysed. The main outcome measure was cumulative rate of deliveries. Any delivery after 25 weeks gestation was included in the study. RESULTS: In women aged 38-39 years, the real cumulative delivery rate after two cycles was 21%, while the expected delivery rate was 26%. In patients aged 40-43 years, the real and expected cumulative delivery rates were 12 and 17% respectively after three cycles, when they reached a plateau. There was only one delivery in the age group >43 years, which consisted of 26 patients with 66 cycles. In women aged >37 years, an expected cumulative delivery rate of 30% may be obtained at the end of the fourth cycle. Women aged >43 years do not have a realistic chance of achieving a delivery with their own oocytes. CONCLUSIONS: This life-table analysis provides a means by which to counsel couples about their chances of achieving a delivery by ICSI at an age >37 years.
BACKGROUND: Female patients aged >37 years have a poor prognosis after ICSI. To determine the cumulative delivery rates in these women by life-table analysis, 228 patients aged >37 years who had undergone a total of 437 ICSI cycles were analysed retrospectively. METHODS: Only cycles in which fresh ejaculated sperm was used, and in which at least one oocyte was micro-injected, were analysed. The main outcome measure was cumulative rate of deliveries. Any delivery after 25 weeks gestation was included in the study. RESULTS: In women aged 38-39 years, the real cumulative delivery rate after two cycles was 21%, while the expected delivery rate was 26%. In patients aged 40-43 years, the real and expected cumulative delivery rates were 12 and 17% respectively after three cycles, when they reached a plateau. There was only one delivery in the age group >43 years, which consisted of 26 patients with 66 cycles. In women aged >37 years, an expected cumulative delivery rate of 30% may be obtained at the end of the fourth cycle. Women aged >43 years do not have a realistic chance of achieving a delivery with their own oocytes. CONCLUSIONS: This life-table analysis provides a means by which to counsel couples about their chances of achieving a delivery by ICSI at an age >37 years.
Authors: Willem Verpoest; Sara Seneca; Marjan De Rademaeker; Karen Sermon; Martine De Rycke; Michel De Vos; Patrick Haentjens; Paul Devroey; Ingeborg Liebaers Journal: J Assist Reprod Genet Date: 2010-03-11 Impact factor: 3.412
Authors: Michaël De Brucker; Herman Tournaye; Patrick Haentjens; Greta Verheyen; John Collins; Michel Camus Journal: J Assist Reprod Genet Date: 2013-08-28 Impact factor: 3.412