PREGNANCY IN WOMEN 50 OR MORE YEARS OF AGE - OUTCOMES OF 22 CONSECUTIVELY ESTABLISHED PREGNANCIES FROM OOCYTE DONATION

Objective: To describe the reproductive and obstetric outcomes of wome n greater than or equal to 50 years attempting pregnancy using donor o ocytes. Setting: The IVF program at the University of Southern Califor nia. Patients: Thirty-six postmenopausal women aged 50 to 59 years, me an 52.3 +/- 2.6 years (mean +/- SD) were screened medically, reproduct ively, and psychologically and enrolled in a trial of oocyte donation. Interventions: Recipients underwent hormone replacement therapy using oral micronized E(2) and IM administered P. Oocytes were provided by designated gamete donors (mean age 30.5 +/- 4.4 years). Embryos (4.3 /- 1.2) were transferred transcervically. Main Outcome Measures: Rates for embryo implantation, spontaneous abortion, ongoing and delivered pregnancies, as well as the gestational age at delivery, birthweights, complications, and postpartum outcomes. Results: Forty-five aspiratio ns resulted in 22 pregnancies (48.9%): 3 preclinical, 2 ending in spon taneous abortion, and 17 viable pregnancies (37.8%). The embryo implan tation rate was 20.6%. Nine of 17 pregnancies (52.9%) were multiple ge stations (6 twins; 1 triplet; and 2 quadruplets, selectively terminate d to twins). All pregnancies delivered beyond 32 weeks: mean gestation al age for singletons was 38.4 +/- 1.9 weeks (range 35 to 41 weeks); m ean gestational age for twins was 36.3 +/- 1.4 weeks (range 34 to 38 w eeks); the triplet pregnancy delivered at 32 weeks. Complications occu rred in eight patients; gestational hypertension (n = 7), preterm labo r (n = 3), gestational diabetes (n = 2), and pre-eclampsia (n = 1). On e infant was trisomy-21. Conclusion: Patients greater than or equal to 50 years experience similar pregnancy rates after oocyte donation as younger women and are at equal risk for multiple gestation. Antenatal complications were experienced by the majority of patients, underscori ng the importance of high risk obstetric surveillance and care.