ART IN WOMEN 40 AND OVER - IS THE COST WORTH IT

OBJECTIVE: To determine the efficacy and cost of assisted reproductive techniques in older women (40 years or older) in comparison to younge r women (less than 30 years old). STUDY DESIGN: Retrospective review o f records from one university-based infertility practice. RESULTS: Wom en 40 years or older were significantly less likely to achieve pregnan cy with human menopausal gonadotropin (hMG)/intrauterine insemination as compared to women under age 30. The older women were also significa nt ly less likely to achieve pregnancy with in vitro fertilization (IV F). The use of donor oocytes resulted in the highest pregnancy rates i n older women. Costs per cycle were similar, however, for both groups. CONCLUSION: Older women will consume an equal amount of medical resou rces per cycle in infertility treatment as compared to younger women ( aged < 30 years). However, older women utilizing assisted reproductive techniques are four to five times less likely to achieve pregnancy th an the younger group. This poor prognosis for success in older women a dds significantly to the mean cost per pregnancy as compared to younge r women. Donor oocytes may be the most cost-effective option for achie ving pregnancy in older women.