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Human Reproduction, Vol. 17, No. 4, 940-944, April 2002
© 2002 European Society of Human Reproduction and Embryology

Cumulative delivery rates after ICSI in women aged >37 years

Kaan Osmanagaoglu,1, Herman Tournaye, Efstratios Kolibianakis, Michel Camus, Andre Van Steirteghem and Paul Devroey

Centre for Reproductive Medicine, Dutch-speaking Brussels Free University, Laarbeeklaan 101, B 1090 Brussels, Belgium

BACKGROUND: Female patients aged >37 years have a poor prognosis after ICSI. To determine the cumulative delivery rates in these women by life-table analysis, 228 patients aged >37 years who had undergone a total of 437 ICSI cycles were analysed retrospectively. METHODS: Only cycles in which fresh ejaculated sperm was used, and in which at least one oocyte was micro-injected, were analysed. The main outcome measure was cumulative rate of deliveries. Any delivery after 25 weeks gestation was included in the study. RESULTS: In women aged 38–39 years, the real cumulative delivery rate after two cycles was 21%, while the expected delivery rate was 26%. In patients aged 40–43 years, the real and expected cumulative delivery rates were 12 and 17% respectively after three cycles, when they reached a plateau. There was only one delivery in the age group >43 years, which consisted of 26 patients with 66 cycles. In women aged >37 years, an expected cumulative delivery rate of 30% may be obtained at the end of the fourth cycle. Women aged >43 years do not have a realistic chance of achieving a delivery with their own oocytes. CONCLUSIONS: This life-table analysis provides a means by which to counsel couples about their chances of achieving a delivery by ICSI at an age >37 years.

Key words: age/cumulative pregnancy rates/delivery/ICSI/life-table analysis

1 To whom correspondence should be addressed at: E-mail: osmanagaoglu{at}hotmail.com


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