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Hum. Reprod. Advance Access published online on April 15, 2008
Human Reproduction, doi:10.1093/humrep/den102
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Success rates and cost of a live birth following fresh assisted reproduction treatment in women aged 45 years and older, Australia 2002–2004

Elizabeth Sullivan1,3, Yueping Wang1, Michael Chapman2 and Georgina Chambers1

1 Perinatal and Reproductive Epidemiology and Research Unit, School Women's and Children's Health, University of New South Wales, McNevin Dickson Building, Randwick Hospitals Campus, Randwick, NSW 2031, Australia 2 Discipline of Obstetrics and Gynaecology, School Women's and Children's Health, University of New South Wales, Royal Hospital for Women, Locked Bag 2000, Randwick, NSW 2031, Australia

3 Correspondence address. Tel: +61-2-9382-1014; Fax: +61-2-9382-1025; E-mail: e.sullivan{at}unsw.edu.au

BACKGROUND: The aim of this study was to calculate assisted reproductive technology (ART) success rates for fresh autologous and donor cycles in women aged ≥45 and the resultant cost per live birth.

METHODS: We performed a retrospective population-based study of 2339 ART cycles conducted in Australia, 2002–2004 to women aged ≥45 years. The cost-outcome study was performed on fresh autologous treatment cycles.

RESULTS: There were 1101 fresh autologous cycles initiated in women aged ≥45, with a pregnancy rate of 1.9 per 100 initiated cycles. There were 21 women who achieved a clinical pregnancy with 15 (71%) ending in early pregnancy loss and 6 in live singleton births. The live birth rate following fresh autologous initiated cycles was 0.5% [95% confidence interval (CI): 0.1–1.0%]. Fresh donor recipients had an higher live birth rate of 19.1% (95% CI: 15.1–23.2) (odds ratio 43.2; 95% CI: 18.6–100.3) compared with women having fresh autologous cycles. The average cost of a live birth following fresh autologous cycles was {euro}753 107.

CONCLUSIONS: The success rate of fresh autologous treatment for women aged ≥45 years was <1%. The very high cost of a live birth reflects a treatment failure rate of >99%. The ART profession should counsel patients of the reality of the technology before the patients consent to treatment.

Key words: donor cycle/maternal age/cost/autologous cycle/assisted reproductive technology

Submitted on October 31, 2007; resubmitted on February 13, 2008; accepted on February 26, 2008.


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