In Vitro Fertilization and Embryo Transfer in Infertile Women over 40 Years of Age: Effects of Previous Conception

Kim, S H; Shim, J Y; Jee, B C; Jung, B J; Suh, C S; Choi, Y M; Kim, J K; Moon, S Y; Lee, J Y

Abstract

It is controversial whether previous conception history serves as a prognostic factor in in vitro fertilization and embryo transfer (IVF-ET). This controversy also exists in older IVF-ET patients, especially over 40 years of age. With increasing age, the natural fecundity decreases and the incidence of miscarriage increases. Thus, many IVF centers restrict the age of patients under 39 years as a requirement for acceptance of IVF-ET. The purpose of this study was to evaluate whether previous conception history could afford better outcomes of IVF-ET in infertile women over 40 years of age. A retrospective study was performed in 49 patients (88 cycles) whose age was 40 years or more and whose infertility factor was only tubal undergoing IVF-ET at Seoul National University Hospital from January, 1994 to December, 1996. The study population was divided in two groups according to previous conception history. There were no statistically significant differences in age (41.4+/-1.3 vs. 41.0+/-1.5 years), serum estradiol (E2) level on hCG day (1,307.5+/-939.7 vs. 1,553.5+/-976.1 pg/ml), number of oocytes retrieved (6.0+/-3.7 vs. 5.8+/-3.7), fertilization rate (74.6% vs. 69.1%), number of embryos transferred (3.8+/-2.3 vs. 3.3+/-1.9), implantation rate (0% vs. 5.6%), and pregnancy and delivery rates per ET (5.3% vs. 20.3%, 0% vs. 8.7%) between primary and secondary infertile groups. In conclusion, previous conception history did not affect the outcomes of IVF-ET in patients over 40 years of age.