Human Reproduction, Vol 13, 884-889, Copyright © 1998 by Oxford University Press
G Grimbizis, M Vandervorst, M Camus, H Tournaye, A Van Steirteghem and P Devroey
The aim of this study was to assess the results of intracytoplasmic sperm
injection (ICSI) in a large cohort of women older than 39 according to age
and to embryo transfer policy. In all, 736 ICSI cycles were analysed
retrospectively. In 576 (78.3%) cycles an embryo transfer was carried out.
The embryo transfer was defined as non-selective when all the available
embryos were transferred, and as selective when fewer than the available
number of embryos were replaced. A statistically significant gradual
decrease in the number of embryos available for transfer, the number of
good or excellent quality embryos available for transfer, the pregnancy
rates, the clinical pregnancy rates, the implantation rates and the viable
pregnancy rates was found with advancing age. No viable pregnancies ensued
in women from 45 years old onwards. There was a statistically significant
gradual increase in the pregnancy rates, the clinical pregnancy rates, the
implantation rates and the viable pregnancy rates from non-selective to
selective transfers. The results were similar in women with five or more
embryos available, irrespective of the embryo transfer policy. It seems,
therefore, that the ovarian reserve and the chances for a successful
pregnancy decrease gradually with advancing age, and it is pointless to
treat women from 45 years old onwards. A subgroup of patients with better
ovarian response and more embryos available for transfer have higher
chances of conception. Conception and implantation rates depend mainly on
the quality of the transferred embryos. However, the implantation capacity
of the embryos is generally lower irrespective of their good morphology.
ARTICLES
Intracytoplasmic sperm injection, results in women older than 39, according to age and the number of embryos replaced in selective or non- selective transfers
Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Belgium.
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