Conventional in vitro fertilization at the age of fourties

Contrary to international guidelines, intracytoplasmic injection (ICSI) has increasingly been applied to a widening range of indications. The aim of this study is to present our experience with conventional in vitro fertilization (C-IVF) in women in their forties and to contribute to the ongoing debate on whether advanced maternal age should be considered an indication for preferring ICSI.

We analyzed cases of non-male factor infertility in women aged ≥40 years. The primary outcome measures were fertilization rate, implantation rate, live birth rate, and miscarriage rate.

The cohort included 204 patients with a mean age of 42.30±1.97 years, a mean antral follicle count of 4.65±2.60, body mass index of 25.80±4.54 kg/m² and a mean duration of infertility of 4.12±4.03 years. The mean duration of stimulation was 8.73±2.22 days, with a mean gonadotropin dose of 261.82±65.25 IU. The fertilisation rate was 74.69%. A mean of 1.77±0.60 embryos were transferred resulting in an implantation rate, clinical pregnancy rate and live birth rate of 10.44%, 18.62%, 12.25% respectively.

Fertilisation, implantation, live birth and miscarriage rates after C-IVF are satisfactory for women ≥40 years of age. Given its lower cost, ease of application and comparable clinical outcomes, C-IVF should be considered the preferred method of fertilisation in advanced-age patients.