Sm. Qasim et al., HIGH-ORDER OOCYTE TRANSFER IN GAMETE INTRAFALLOPIAN TRANSFER PATIENTS40 OR MORE YEARS OF AGE, Fertility and sterility, 64(1), 1995, pp. 107-110
Objective: To analyze whether a policy of high-order oocyte transfer w
ould be effective in women greater than or equal to 40 years of age wh
o are undergoing GIFT, and further, whether a specific subgroup of the
se patients could be identified where clinical pregnancy was more like
ly to occur. Design: Prospective descriptive study. Setting: Patients
in a university-based reproductive endocrinology and infertility pract
ice. Patients: Infertile women greater than or equal to 40 years of ag
e who underwent GIFT cycles between January, 1990 and December, 1993 a
fter not having achieved pregnancy with at least three previous cycles
of superovulation and intrauterine insemination. Interventions: Gamet
e intrafallopian transfer was performed after controlled ovarian hyper
stimulation with hMGs. High-order oocyte transfer was employed. Main O
utcome Measures: Clinical pregnancy rates (PRs). Results: The overall
clinical PR was 24.5% per retrieval (12/49) and 25.5% per transfer (12
/47). A significantly higher number of oocytes were retrieved in patie
nts who became pregnant than those who did not. Patient age, cycle day
3 FSH level, E(2) level on the day of hCG administration, number of o
ocytes transferred, and total number of motile sperm transferred did n
ot differ significantly between the two groups. The clinical PR per tr
ansfer was significantly higher in patients with more than five oocyte
s transferred (10/27, 37%) versus those with five or less oocytes tran
sferred (2/20, 10%). No multiple gestations were obtained. Conclusion:
The number of oocytes retrieved in women greater than or equal to 40
years of age undergoing GIFT is the main determinant predicting clinic
al pregnancy. High-order oocyte transfer seems to lead to a favorable
PR while the risk of multiple gestation is limited.