SUCCESSFUL DELIVERY AFTER AGE 50 - A REPORT OF 2 CASES AS A RESULT OFOOCYTE DONATION

Background: Because of donor oocyte programs, women who previously wer e considered too old to successfully achieve conception and delivery c an now bear children. To our knowledge, there have been no previous re ports of pregnancy outcome in women over age 50 who conceived using do nor oocytes. This study presents the pregnancy and delivery data on tw o women who delivered at age 52. Cases: Case 1 was a 51-year-old woman , gravida 3, para 3, whose three children had been conceived with her first husband more than 20 years previously. She had remarried 18 year s before presentation and had been actively trying to conceive for the last 7 years. She was diagnosed as being in menopause based on elevat ed gonadotropins, amenorrhea, and failure to have progesterone-withdra wal menses. She conceived on her first embryo transfer cycle with embr yos derived from donor oocytes and fertilized by her husband's sperm ( oocytes were donated by a woman who was undergoing retrieval for in vi tro fertilization). During pregnancy she remained healthy, but had ute rine prolapse at 20 weeks. She delivered a normal healthy male at 40.5 weeks; cesarean was performed because of a presumptive diagnosis of f etal distress after 3 hours of labor, when monitoring revealed fetal h eart decelerations. Case 2 was also a 51-year-old woman, gravida 6, pa ra 4, who wished to conceive with her second husband's sperm through t he donor oocyte program. She had amenorrhea of 2 years' duration and e levated gonadotropins. Conception occurred after fertilization of a do nor oocyte by her husband's sperm. She had an uneventful pregnancy, bu t labor was induced at 38 weeks' gestation given the supposed high-ris k status of this age group. Apgar scores were 8 and 9 at 1 and 5 minut es, respectively. Conclusion: Theoretically, the risks of pregnancy co mplications in older patients are magnified given the aging maternal c ardiovascular system, which may predispose these women to placental in sufficiency. These first two cases of donor oocyte pregnancies in wome n over age 50 found no maternal or fetal age-related complications. We hope these reports will encourage all researchers to share their find ings so that prospective patients can make better, more informed decis ions as to whether they want to participate in donor oocyte programs.