The chance of pregnancy per cycle decreased progressively with advancing age. In our practice over the last decade, the chance of pregnancy with donor insemination in women under age 35 has been 16% per cycle, while those between the ages of 35 and 40 have a 12% chance per cycle. In women between the ages of 40 and 45, the chance falls to 6% per cycle. In women in their late 30's, about one third have a fertility problem and about half of those over age 40 are infertile. This decline in reproductive function related to age is also seen in the population undergoing IVF.
Many studies have documented the effect of age on IVF outcome. Scott, et. al. showed in 1995 a progressive decline in the chance of pregnancy from 62.8% in women <30 to 5.6% in women >40. Roest, et. al., in 1996 showed a greater likelihood of poor response to stimulation with advancing age, as well as fewer oocytes retrieved, a lower pregnancy rate, a higher rate of spontaneous abortion, and a lower rate of multiple pregnancy. In 1997, Lim and Tsakok showed that the fertilization rate of oocytes from older women was no less than in those from younger women, despite fewer oocytes being retrieved. Pregnancy rates were substantially different, however, with 43% of women <34 years of age conceiving, compared to 14% of those >40 years old.
When intracytoplasmic sperm injection (ICSI) is performed, the age-related chance of success is still present. Alrayyes, et. al. reported in 1997 that younger patients had better implantation rates, clinical pregnancy rates, and ongoing pregnancy rates despite having ICSI performed.
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