Standard in vitro fertilization or intracytoplasmic sperm injection in advanced female age - what may be expected?

This study was conducted to evaluate the current remits of standard in vitr o fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in the el derly (greater than or equal to 40 years of age) female population. Oocyte recovery, fertilization, embryo transfer, pregnancy and cumulative pregnanc y rates were assessed. The results were analyzed for: the entire elderly po pulation; the standard IVF group (group 1); all those in the ICSI group (gr oup 2); ann ICSI for severe male-factor category (group 3). A total of 330 IVF and 158 ICSI treatment cycles were carried out in 249 women. Forty-five (9.2%) clinical pregnancies were achieved. This rate was not statistically different from those achieved for groups 1, 2 and 3 (9.1%, 9.5% and 6.8%, respectively). The cumulative pregnancy rate for a total of five cycles was 19.2% and 26.4% for groups 1 and 2, respectively. For those who started th eir treatments at greater than or equal to 40 years, the cumulative pregnan cy rate for three cycles was 26.5% and 36.5% in groups 1 and 2, respectivel y. These results clearly demonstrate that female age is a major success det erminant, with similar influence on both standard IVF and ICSI therapy moda lities.