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Evaluating the Cumulative Live Birth Rate in Autologous In Vitro Fertilization Cycles in Women Aged 40 Years and
Pallavi Prasad1, Soumya Shetty2, Sonia Malik3
1Department of Reproductive Medicine, Nova IVF Fertility, Bengaluru, Karnataka, India.
Background:
In present times, many women in their forties are seeking fertility treatment because of delayed marriage and childbearing. They often face the dilemma of whether to try in vitro fertilisation (IVF) with self-oocytes or donor oocytes. Quoting IVF success in terms of per oocyte pick-up (OPU) or per embryo transfer (ET) cycle can be misleading, as many patients undergo pooling IVF cycles or use PGT-A for best embryo selection. Cumulative live birth rate (CLBR) per woman offers a more realistic measure of treatment efficacy, best suited for patient counselling.
Aim:
To evaluate CLBR in self-oocyte IVF cycles in women more than 40 years of age.
Settings And Design:
Retrospective study analysing patient data from the electronic medical record system of various centres of a single fertility chain between January 2019 and December 2023.
Materials And Methods:
Women aged >40 years who underwent one or more oocyte retrievals using self-eggs were included. Exclusion criteria were donor oocyte cycles and oocyte cryopreservation cycles. Reproductive outcomes included clinical pregnancy rate (CPR), miscarriage rate (MR) and CLBR per woman.
Statistical Analysis Used:
Data was analysed using descriptive and inferential statistics. Continuous and categorical variables were summarised as frequencies and percentages. Age was grouped, and treatment outcomes (OPU, embryo availability, ET, clinical pregnancy, miscarriage and live birth) were expressed as proportions by age group. Distribution between age and categorical outcomes was assessed using the Chi-square test of independence, with significance set at P < 0.05. Analyses were performed using SPSS version 21.0.
Results:
Among 1,088 women (mean age: 41.56 ± 1.82 years), embryo formation occurred in 69.67% and ET in 62.22%. The CPR was 17.92%, MR 40%, and live birth rate 10.75%. CLBR per woman declined steeply with increasing age - 14.35% at 40 years, 9.63% at 42 years, and 0% beyond 47 years (P < 0.05).
Conclusion:
CLBR in women aged >40 years declines markedly with advancing age, with negligible live birth rates beyond 45 years despite multiple cycles.
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