Clinical Results of In Vitro Fertilization or Intracytoplasmic Sperm Injection Treatments in Women Aged 40 Years and above

Objective:The study was designed to estimate the live birth rate(LBR)and cumulative LBR(CLBR)in patients aged≥40 years undergoing in vitro fertilization or intracytoplasmic sperm injection treatments during their first and multiple ovarian stimulation cycle(s).Methods:A total of 697 advanced women underwent 1,293 treatment cycles,and 973 fresh embryo transfers were performed.The LBR and CLBR were analyzed with respect to an increase in the maternal age by every year.Results:A declining trend in LBR and CLBR of the first cycle was seen with an increase in maternal age.The LBR in women aged 40 years was significantly higher than that in women aged≥44 years(18.39%and 4.39%,respectively);the CLBR in women aged 40 years was also significantly higher than that in women aged 42,43,and≥44 years(22.40%,9.09%,9.09%,and 4.80%,respectively).However,there was no significant difference(P>0.05)in the rate of miscarriage among all groups.For those who underwent multiple cycles,the number of live-born babies decreased rapidly after three ovarian stimulation cycles;the LBR in patients aged 40 years was significantly higher than that in patients aged 42 years and≥44 years(15.24%,5.20%,and 4.49%,respectively),and the CLBR in patients aged 40-41 years was significantly higher than that in patients aged≥42 years.The CLBR in all groups gradually plateaued after three cycles;women aged 40-41 years achieved relatively reasonable CLBR,while the CLBR was<10%in women aged≥42 years.Conclusions:Women aged 40-41 years had a low but acceptable outcome in the first three ovarian stimulation cycles.The success rate quickly decreased,and for women aged≥42 years,the decision to continue after three ovarian stimulation cycles should be made cautiously.