THE OVARIAN RESPONSE AS A PREDICTOR FOR SUCCESSFUL IN-VITRO FERTILIZATION TREATMENT AFTER THE AGE OF 40 YEARS

Objective: To determine whether age or response to controlled ovarian hyperstimulation (COH) is a better predictor of IVF outcome in women g reater than or equal to 40 years. Design: Retrospective analysis. Sett ing: A transport IVF program. Patient(s): For patients undergoing IVF treatment the correlation between treatment outcome and age and respon se to COH was analyzed using the data of 2,588 consecutive cycles. Int ervention(s): None. Main Outcome Measure(s): Pregnancy. Result(s): The incidence of poor ovarian response rises significantly with increasin g age. Analysis of all cycles showed a significant decrease in clinica l and ongoing pregnancy rate for women greater than or equal to 40 yea rs. Analysis of cycles with a good ovarian response showed no statisti cally significant differences for these parameters between women great er than or equal to 40 years and those younger. A logistic regression analysis on pregnancy showed that ovarian response contributes more to the prediction of pregnancy than age. Conclusion(s): Patients aged gr eater than or equal to 40 years with a good response to COH have a goo d prognosis for IVF treatment. The age limit for acceptance of patient s should not be set at 40 years. Instead, the response to COH can be u sed to predict candidates likely to have a successful IVF outcome.