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. 2014 Jun;55(6):305-9.
doi: 10.11622/smedj.2014081.

Female ageing and reproductive outcome in assisted reproduction cycles

T Y Tan, S K Lau  1 , S F Loh, H H Tan
Affiliations

Female ageing and reproductive outcome in assisted reproduction cycles

T Y Tan et al. Singapore Med J. 2014 Jun.

Abstract

Introduction: Fertility in women declines with increasing age. With the deferment of marriage and childbearing, couples are turning to assisted reproductive technology to counteract this decline. We aimed to evaluate the results of in vitrofertilisation (IVF)/intracytoplasmic sperm injection (ICSI) in women of different age groups, and highlight the cost-effectiveness of IVF treatment in these groups while assessing its implications on the national healthcare provision model.

Methods: Retrospective analysis of 3,412 stimulated IVF/ICSI cycles in a hospital-based IVF centre was performed from January 2008 to December 2010. Patients were stratified into seven age groups: < 30 years; 30-35 years; 36-37 years; 38 years; 39 years; 40-44 years; and ≥ 45 years.

Results: Age had a significant effect on the number of cycles leading to embryo transfer (p < 0.001). The number of oocytes retrieved decreased across the various age groups (p < 0.001) and was the highest among women aged < 30 (mean 18.5 ± 10.3) years. With increasing age, there was a trend toward a lower fertilisation rate. Age also had a significant effect on the rates of clinical pregnancy, live birth and multiple pregnancies (p < 0.001).

Conclusion: Patients aged < 30 years had the best IVF outcomes, reflecting optimal reproductive capacity. Age-related decline in fertility starts after 30 years. Women opting for IVF should be counselled about age-specific success rates while taking into account individual risk factors.

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Figures

Fig. 1
Fig. 1
Percentage of fresh cycles reaching embryo transfer in the various age groups.
Fig. 2
Fig. 2
Comparison of the average number of oocytes collected per cycle among the various age groups.
Fig. 3
Fig. 3
Comparison of the embryo fertilisation rates among the various age groups.
Fig. 4
Fig. 4
Comparison of the mean duration of stimulation among the various age groups.
Fig. 5
Fig. 5
Comparison of clinical outcomes among the various age groups.
Fig. 6
Fig. 6
Comparison of age-specific marriage rates in Singapore for 2000 and 2010. Source: Singapore Department of Statistics(14)
Fig. 7
Fig. 7
Comparison of age-specific fertility rates in Singapore for 2000 and 2010. Source: Singapore Department of Statistics(15)
See this image and copyright information in PMC

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