Natural-cycle in vitro fertilization women aged over 44 years

Women who are 44 years of age or more are usually denied infertility treatm ent because of their low response to ovarian stimulation and the extremely low pregnancy rate that can be achieved. The object of this study was to as sess the place of natural-cycle in vitro fertilization (IVF) in this popula tion. From January 1996 to September 1997, all consecutive women aged 44-47 years who approached our unit seeking infertility treatment with their own oocytes were enrolled in the study. After a counselling session in which t he advantage of egg donation was discussed, women who still wished to try t o conceive by utilizing their own oocytes were treated according to the fol lowing protocol. Ultrasound and hormonal surveillance was carried out start ing 5 days prior to the presumed ovulation day, based on previous menstrual history. Ovum pick-up was timed either by detection of the luteinizing hor mone surge or by human chorionic gonadotropin administration. In total, 48 treatment cycles were conducted in 20 women. Oocyte retrieval was successfu l in 22 cycles. Fertilization and cleavage rates of 48% and 100%, respectiv ely, were detected. Nine of the 12 embryos transferred were defined as grad e A. One chemical and one ongoing pregnancy were achieved. We conclude that , despite the fact that high-quality embryos can be obtained in this popula tion, the likelihood of pregnancy is low.