Obstetric and prenatal outcome in menopausal women: a 12-year clinical study

The obstetric and prenatal outcome in post-menopausal women of advanced age in an oocyte donation programme is described in this paper, the oldest being aged 63 years. A total of 2729 candidates were visited up to November 2000. Only 1150 (42%) were accepted, with 1579 being rejected during a rigorous selection procedure. Several excluding clinical conditions were noted, including hypertension of varying severity, cardiovascular disease, smoking, dysfunctions of the hepatic, thyroid and renal systems and diabetes. Overall, 489 (38%) clinical pregnancies were established in 1288 recipient cycles, with 390 healthy babies delivered out of 363 pregnancies (28%), while 126 (25.7%) were lost. In all, 327 (90%) of the pregnancies reached full term, with 36 involving premature deliveries, 24 involving multiple gestation, 21 sets of twins, three sets of triplets (0.9%) and no quadruplets. Antenatal complications arising in 86 patients (23.6% of deliveries) included 33 preterm deliveries, 43 cases of gestational hypertension, four cases of pre-eclampsia, three cases of gestational diabetes and three of abruptio placentae. A total of 272 (75%) of all deliveries were by Caesarean section. Neonatal complications included two cases of growth retardation. There were no neonatal or maternal deaths. The 63-year-old woman reached full term pregnancy in July 1994, with delivery by Caesarean section of a boy in good health. Proper screening for risks has enabled this treatment to be given to a preselected group of patients.