[Influence of advanced age on the outcome of in vitro fertilization and embryo transfer].

Objective: To determine the influence of age on the outcome of In vitro fertilization and embryo transfer (IVF-ET).

Methods: A retrospective study of 139 cycles of conventional IVF and 69 intracytoplasmic sperm injection (ICSI) cycles was performed between January 1999 and December 1999.

Results: A total of 208 patients (age 36 to 45 years) after IVF or ICSI were divided into five age groups (36 years group, n = 78; 37 years group, n = 49; 38 years group, n = 50; 39 years group, n = 18; 40 approximately 45 years group, n = 13). Pregnancy rate is 23.1%. There appear to be no significant difference between infertility duration, IVF cycles, fertilization rate and cleavage rate, the number and the quality of embryos transferred, and the prenatal outcome in each age group. But with the age growing, the number of follicles in each group decreased significantly (14.7 +/- 1.2, 13.0 +/- 2.0, 11.3 +/- 0.9, 9.7 +/- 0.9 and 6.5 +/- 1.9 respectively), the pregnancy rate were significantly lower (24.1, 20.5, 13.2, 11.1 and 9.8% respectively), implantation rate were significantly lower too (15.6, 11.2, 10.5, 6.5 and 2.2% respectively). But the abortion rate increase significantly (23.0, 27.2, 33.4, 41.2 and 43.3% respectively), and multiple pregnancy rate decreased (31.2, 27.3, 15.4, 6.7 and 0.0% respectively). The pregnancy rates of the ICSI and IVF were similar after stratification by age.

Conclusions: The fecundity reduct significantly at the age older than 36 years old. It reduct more obviously when the age older than 40 years old. Transferring four or more embryos may increase pregnancy rate, but without increasing multiple pregnancy in women older than 40 years.