Pushing the Boundaries of Fertility: insights from a case Series of IVF Outcomes in Women 40 and Older

Document Type : Original Article

Authors

1 Obstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Egypt.

2 Egyptian Foundation of Reproductive Medicine and Embryology, Egypt.

3 Madina Fertility Center, Madina Women’s Hospital, Alexandria, Egypt.

Abstract

Advanced maternal age (AMA; >35 year) is a critical social and clinical issue. It is associated with a decline in both ovarian reserve and oocyte competence. At present, no remedies are available to counteract the aging-related fertility decay, however different therapeutic approaches can be offered to women older than 35 year undergoing IVF to improve clinical pregnancy rate such as PGS.This retrospective study was carried out in the ART Unit of El-Madina Fertility Center involving 213 infertile women performed ICSI for infertility management with different protocols of stimulation aiming to compare the clinical and laboratory outcomes of Natural cycle, Agonist, Antagonist, Agonist -stop, Short Agonist, Short Antagonist, PPC (progesterone prime cycle) protocols in women under and over 40 years undergoing ICSI to evaluate the effect of age on fertility outcomes. Results: The mean of level of E2, number of retrieved oocytes, number of mature oocytes (MII), number of injected oocytes, fertilization rate, number of embryos formed, and clinical pregnancy rate were statistically significant higher in women under 40 than in women over 40 years (P <0.001*). Conclusions: Retrieval/Pregnancy/pregnancy rates and ICSI laboratory outcomes are significantly lower in infertile women with aging especially over 40 years.

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