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Do Older Women Need More Embryos?

ASRM
17 October 2007
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Washington, DC – Several new research studies presented at the American Society for Reproductive Medicine meeting tackled the question of how best to help older women seeking to have children. 

Using data collected by the Society for Assisted Reproductive Technology (SART) the SART writing group analyzed data from IVF cycles performed between 2000 and 2004. They examined records of more than 5500 cycles performed in women over age 37. They found that for 38 and 39 year olds, compared to a single embryo transfer, the use of up to two embryos increased the number of cycles leading to a live birth; however transferring more embryos did not increase the delivery rate, but did increase the number of multiple births. For women age 40, using 3 embryos did increase the delivery rate, but not the multiple-birth rate. For women aged 41 and 42, transferring more than 2 embryos did not increase the delivery rate, but did increase the number of twins.

Another study by that same research team evaluated more than 38,000 cycles in women over age 37. They found that for 38 and 39 year old women both delivery rates and rates of multiple-birth rates increased as the number of embryos transferred increased to 3. Transferring more than 3 embryos did not increase pregnancy rates for this age group. Forty year old patients did see an increase in pregnancy rates as well as rates of multiple gestations.

A team from the Robert Wood Johnson Medical School found that increasing the number of embryos transferred in patients over age 40 could increase their pregnancy rates.

A team of researchers in Houston and Colorado analyzed nearly 300 cycles done on 41 and 42 year old patients in their programs. They used the outcomes of those cycles to create a mathematical model that projects that cycles using up to 6 embryos for patients over age 40 would result in very few multiple gestations.

In Connecticut, insurance companies are required to offer coverage for infertility patients up to age 40. Researchers found that women beyond age 40 were treated successfully. The live birth rate for 43 year olds was 10% and for 44 year old patients it was 5.4%.

“SART is committed to collecting and using data to ensure we provide our patients the best care possible. We are constantly striving to maximize the chances for each patient to have a safe successful singleton pregnancy,” said David Grainger, MD, MPH, President of the Society for Assisted Reproductive Technology (SART).

O-75, Stern et al, Optimizing the Number of Cleavage Stage Embryos to Transfer on Day 3 in Women 38 and Older: A SART Database Study
O-167, Optimizing the Number of Blastocyst Stage Embryos to Transfer in Women 38 and Older: A SART Database Study

P-110, Hickman et al, Are We Justified in Transferring more Embryos in Older Women?

P-519, Katsoff et al, In Contrast to Younger Women, the Transfer of 2 or 3 Embryos in Women Aged 40-42 with Increases Day Three Serum Follicle Stimulating Hormone (FSH) Markedly Improves Pregnancy Rates (PRs) Jerome Check, MD, PhD presenting. 

P-515, Cetinkaya et al, Reproductive Outcome of Women > 43 Years Old Undergoing ART Treatment with their own Oocytes Pasquale Patrizio, MD contact for discussion.



The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 8,000 physicians, researchers, nurses, technicians, and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, The Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, and the Society of Reproductive Surgeons. 



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