ENDOMETRIAL RECEPTIVITY - THE AGE-RELATED DECLINE IN PREGNANCY RATES AND THE EFFECT OF OVARIAN-FUNCTION

Objective: To assess the effect of age and ovarian function on endomet rial receptivity. Design: Retrospective comparison between standard IV F and ovum donation in younger and older patients (<40 and greater-tha n-or-equal-to 40 years of age, respectively). Patients: In standard IV F, there were 325 transfer cycles in older patients and 1,103 transfer cycles in younger ones. In ovum donation, there were 236 transfer cyc les in older patients and 222 cycles in younger women. Ovum recipients were then redivided into two groups, according to ovarian function: o varian failure group (219 cycles) and eugonadal group (239 cycles) in patients with retained ovarian function as manifested by regular menst rual cycles and normal gonadotropins. Results: In standard IVF, clinic al pregnancy rates (PRs) were significantly lower in older patients (1 2.9% versus 23.8%, respectively). In ovum donation, clinical PRs were also significantly lower in older patients (21.2% versus 29.3%, respec tively). A significantly higher clinical PR (31.1%) was noted in patie nts with ovarian failure, compared with both eugonadal patients underg oing ovum donation (19.7%) and standard IVF patients (21.3%). Conclusi ons: The decrease in endometrial receptivity with age is responsible f or the higher rate of implantation failure in older women. Patients wi th nonfunctioning ovaries do better than eugonadal patients in ovum do nation programs.