A prospective descriptive cohort study of women aged ≥40 years conceiving through IVF at a tertiary care center

To describe obstetric and perinatal outcomes of pregnant women with advanced maternal age (AMA) conceiving through in vitro fertilization (IVF) technology.

A single-center prospective observational study was conducted between January and December 2024. All women aged 40 and older who conceived via IVF were included. Participants underwent regular prenatal follow-up in a maternal-fetal unit, including standardized maternal clinical assessment and fetal ultrasound evaluation. A subgroup analysis (40-44-year-old subgroup vs. ≥45-year-old subgroup) was also conducted to identify potential differences in obstetric and perinatal outcomes within our study population.

A total of 128 pregnant women were included. Nearly half were primigravid (n = 60, 46.88%) and 71 pregnancies resulted from oocyte donation (55.47%). Obstetric complications observed in this cohort included gestational diabetes mellitus (n = 3, 2.34%), hypertensive disorders (n = 6, 4.76%) preterm premature rupture of membranes (n = 11, 8.59%), preterm intrauterine growth restriction (n = 7, 5.56%) and preterm delivery (n = 15, 11.72%). It is noteworthy that these last three outcomes mentioned were observed significantly more frequently in the subgroup aged over 45 years. Cesarean delivery was performed in 62 cases (49.6%). Regarding neonatal outcomes, the median birth weight was 3,028 g and the median umbilical cord pH was 7.29. Eight newborns (6.45%) required admission to intensive care unit. Postnatal comorbidities were identified in 14 infants, with respiratory complications being the most frequent (12/14).

In this cohort of women of AMA following IVF, several obstetric and neonatal complications were observed. Additionally, the subgroup analysis revealed that PPROM, preterm IUGR and preterm delivery, lower neonatal weight and respiratory complications were significantly more frequent among women aged 45 or older. These findings provide descriptive clinical data regarding pregnancies in this specific population, which remains relatively underrepresented in the literature. Given the single-center design of the study, further research, including studies with appropriate comparison groups and larger sample size conducted across multiple centers, are needed to better clarify the individual and combined contributions of AMA and IVF to these outcomes.