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Human Reproduction, Vol. 7, No. 8, pp. 1106-1110, 1992
© 1992 European Society of Human Reproduction and Embryology

other

The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women

Talha Al-Shawaf1, Aonghus Nolan, Rifky Guirgis, Joyce Harper, Meryl Santis and Ian Craft

London Fertility and Gynaecology Centre, Cozens House 112a Harley Street, London WIN 1AF, UK

Correspondence: 1To whom correspondence should be addressed

Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum {beta}-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1—3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4–10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonado-trophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged ≥40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.

Key words: gamete intra-Fallopian transfer/older aged women/ovarian response/pregnancy rate


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