Embryo quality and developmental potential is compromised by age

Aims: The aim of this retrospective study was to assess whether and how the age of the woman affects the quality and developmental potential of the oo cytes and embryos in an ART program. Method and material A total of 878 IVF cycles was included as a consecutive series of single transfers (n=292), dual transfers (n=366) and triple tran sfers (n=220), where all the transferred embryos in each cycle were of iden tical quality score and identical cleavage stage. Results. We found a highly significant decrease in oocyte recovery with inc reasing age with about one oocyte per 2.3 years (95% CI 1.8 years to 3.1 ye ars, p<0.0001). Further, we found that the number of oocytes that cleaved d eclined significantly with increasing age with one per 3.7 years (95% CI 2. 7 years to 5.5 years, p<0.0001). This decline was mainly due to the decline in number of oocytes retrieved as the ratio of aspirated oocytes that clea ved with increasing age (approx. -0.04/10 year 95% CI: -0.10; +0.009) was n ot significantly different (p=0.10). The percentage of transfers using frag mented embryos did not increase significantly with increasing age (p=0.08). The odds of fragmentation increased by 3% per year. The average number of embryos transferred decreased significantly (p=0.03) with age from approxim ately 2.1 at the age of 25 to approximately 1.8 at the age of 40. In a sele cted subgroup of embryos all consisting of good quality embryos, a signific ant decrease was found in implantation rate with increasing age (approx. -0 .08/10 years, 95% CI: -1.6; +0.00, p=0.05). Of the 357 pregnancies achieved in this study we found a significantly decreased ongoing pregnancy rate an d a significantly increased abortion rate with increasing age (p=0.03). The decrease in the rate of ongoing pregnancies was almost linear, decreasing by approximately 1.5% per year. Conclusions. We conclude that age has an impact throughout a woman's reprod uctive life and that it is important to realize that the age-related declin e in fertility may start already in the late twenties and not in the mid-th irties as is generally assumed.