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Collection of Human Follicular Fluid, Follicle Somatic Cells, and Immature Oocytes from Individuals Undergoing In Vitro Fertilization
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Getting Older Women Pregnant: Contemporary Thoughts.

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PubMed
Summary

Mild ovarian stimulation offers a cost-effective IVF approach for older women, yielding higher-quality eggs. Accumulating vitrified embryos with genetic screening may improve success rates for this demographic.

Keywords:
AMHIUIIVFIVF liteMinimal stimulation IVFNGSOlder patientsPGDPGSPreimplantation genetic diagnosisPreimplantation genetic screeningTrophectoderm biopsyVitrification

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Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization (IVF)
  • Genetics

Background:

  • Standard hormonal stimulation for IVF in older women with elevated FSH is costly and has low success rates.
  • Mild ovarian stimulation protocols yield a higher proportion of good-quality eggs compared to conventional methods.
  • Older women undergoing IVF face challenges due to a limited number of embryos for transfer.

Purpose of the Study:

  • To evaluate the efficacy and cost-effectiveness of mild ovarian stimulation protocols in IVF for women of advanced age.
  • To explore embryo accumulation strategies using vitrification and preimplantation genetic screening for older women undergoing IVF.
  • To determine if these approaches can improve IVF success rates in older women.

Main Methods:

  • Comparison of mild ovarian stimulation protocols versus conventional high-dose stimulation.
  • Accumulation of vitrified embryos from multiple minimal stimulation and natural cycles.
  • Application of preimplantation genetic screening using next-generation sequencing on accumulated embryos.

Main Results:

  • Mild stimulation reduces stimulation duration, gonadotropin dosage, and oocyte retrieval numbers but increases the proportion of high-quality and euploid embryos.
  • Pregnancy rates per embryo transfer are comparable to conventional protocols.
  • Vitrification technologies enable efficient embryo accumulation, creating a pool of chromosomally normal embryos.

Conclusions:

  • Mild ovarian stimulation is clinically and cost-effective, with better patient tolerability.
  • Embryo accumulation via vitrification and subsequent genetic screening offers a promising strategy to enhance IVF success for older women.
  • This approach has the potential to equalize success rates between older women and normal responders.