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Fertility treatment in the forty and older woman
A Auyeung1, M E Klein, V S Ratts
1Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108-2259, USA.
Purpose:
To determine the outcomes and logical progression of fertility treatment in women forty years and older using their own oocytes.
Methods:
This was a retrospective study in which 401 completed treatment cycles in 152 women aged forty and older were reviewed.
Results:
Assisted reproductive technology (ART) cycles (n = 58) were reviewed, comprising both in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Intrauterine insemination (IUI) cycles (n = 343) were reviewed, consisting of 38 unstimulated natural cycle-IUI (NC-IUI), 194 clomiphene citrate-IUI (CC-IUI), and 111 injectable gonadotropins-IUI (INJ-IUI) cycles. The live birth rate of 15.5% for ART cycles was significantly higher than the live birth rate of 3.2% seen for all IUI cycles (p = 0.0007). There were no differences among treatment groups in spontaneous abortion, preterm delivery, or ectopic pregnancy rates.
Conclusions:
For women > or = 40 years of age who wish to use their own eggs, ART offers the best chances for conception and delivery.