Counselling post-menopausal women for donor in-vitro fertilization and hormone replacement therapy

Oocyte donation was applied initially to women with hypergonadotrophic hypogonadism or 'premature menopause'. Later, therapy was extended to recipients > 40 years old and to post-menopausal women. In all cases, enhanced implantation and pregnancy rates were obtained by many investigators. Post-menopausal women must be informed about in-vitro fertilization results, obstetric risks for themselves and their newborn babies. They must be screened and investigated as accurately as possible for any existing medical contraindication. Results are encouraging because these patients become pregnant as easily as young donors, with pregnancy rates of 58, 34.6 and 37.9% per patient, per synchronization cycle and per transfer respectively. Abortion rates (5%) are very low considering the women are > 45 years old. The post-menopausal uterus can sustain implantation, grow and carry pregnancy to term and reduce adequately after labour. The incidence of maternal morbidity during pregnancy is less encouraging. A higher incidence of pregnancy-related diseases, e.g. gestational diabetes, hypertension, moderate and severe pre-eclampsia have been reported.