INTRACYTOPLASMIC SPERM INJECTION, RESULTS IN WOMEN OLDER THAN 39, ACCORDING TO AGE AND THE NUMBER OF EMBRYOS REPLACED IN SELECTIVE OR NONSELECTIVE TRANSFERS

The aim of this study was to assess the results of intracytoplasmic sp erm injection (ICSI) in a large cohort of women older than 39 accordin g to age and to embryo transfer policy. In all, 736 ICSI cycles were a nalysed retrospectively. In 576 (78.3%) cycles an embryo transfer was carried out. The embryo transfer was defined as non-selective when all the available embryos were transferred, and as selective when fewer t han the available number of embryos were replaced. A statistically sig nificant gradual decrease in the number of embryos available for trans fer, the number of good or excellent quality embryos available for tra nsfer, the pregnancy rates, the clinical pregnancy rates, the implanta tion rates and the viable pregnancy rates was found with advancing age . No viable pregnancies ensued in women from 45 years old onwards. The re was a statistically significant gradual increase in the pregnancy r ates, the clinical pregnancy rates, the implantation rates and the via ble pregnancy rates from non-selective to selective transfers. The res ults were similar in women with five or more embryos available, irresp ective of the embryo transfer policy. It seems, therefore, that the ov arian reserve and the chances for a successful pregnancy decrease grad ually with advancing age, and it is pointless to treat women from 45 y ears old onwards, A subgroup of patients with better ovarian response and more embryos available for transfer have higher chances of concept ion, Conception and implantation rates depend mainly on the quality of the transferred embryos. However, the implantation capacity of the em bryos is generally lower irrespective of their good morphology.