Consecutive cycles in in vitro fertilization--embryo transfer.

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization
• Geriatric Gynecology

Background:

• Female fertility significantly decreases with increasing maternal age.
• Ovarian performance is a critical factor in successful fertility treatments.
• Repeated ovarian stimulation cycles are common in in vitro fertilization (IVF).

Purpose of the Study:

• To compare ovarian performance across different age groups undergoing repeated IVF cycles.
• To evaluate the impact of maternal age on ovarian response to stimulation.
• To analyze changes in ovarian response within individuals over consecutive IVF cycles.

Main Methods:

• Retrospective analysis of 400 patients undergoing at least three IVF cycles between 1998-2002.
• Patients categorized into four age groups: 25-30, 31-35, 36-40, and 41-45 years.
• Comparison of gonadotropin dosage, follicle count, oocyte yield, and embryo quality across age groups and cycles.

Main Results:

• Increased recombinant follicle-stimulating hormone (rFSH) dosage was required in subsequent cycles and significantly higher in older age groups.
• Women aged 36-45 had significantly fewer follicles, oocytes, and lower proportions of grade A embryos compared to younger women.
• Age-independent decline in ovarian response was observed, with only gonadotropin dosage showing significant differences in repeated cycles within age groups.

Conclusions:

• Advanced maternal age negatively impacts ovarian performance in IVF.
• Repeated IVF cycles show an age-independent decline in ovarian response, particularly concerning gonadotropin requirements.
• Fertility treatments must consider the age-related decline in ovarian function for optimized outcomes.