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The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women
Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A...
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| Published in: | Human reproduction (Oxford) 1992-09, Vol.7 (8), p.1106-1110 |
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| Main Authors: | , , , , , |
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| container_issue | 8 |
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| container_title | Human reproduction (Oxford) |
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| creator | Al-Shawaf, Talha Nolan, Aonghus Guirgis, Rifky Harper, Joyce Santis, Meryl Craft, Ian |
| description | Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum β-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1—3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4–10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonado-trophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged ≥40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment. |
| doi_str_mv | 10.1093/oxfordjournals.humrep.a137802 |
| format | article |
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The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum β-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1—3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4–10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonado-trophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged ≥40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. 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The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum β-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1—3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4–10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonado-trophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged ≥40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.</description><subject>Adult</subject><subject>Aging - physiology</subject><subject>Biological and medical sciences</subject><subject>Buserelin - therapeutic use</subject><subject>Chorionic Gonadotropin - blood</subject><subject>Chorionic Gonadotropin, beta Subunit, Human</subject><subject>Clomiphene - therapeutic use</subject><subject>Female</subject><subject>Follicle Stimulating Hormone - therapeutic use</subject><subject>gamete intra-Fallopian transfer</subject><subject>Gamete Intrafallopian Transfer</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Menotropins - therapeutic use</subject><subject>older aged women</subject><subject>Oocytes - physiology</subject><subject>ovarian response</subject><subject>Ovary - physiology</subject><subject>Peptide Fragments - blood</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>pregnancy rate</subject><issn>0268-1161</issn><issn>1460-2350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><recordid>eNpVkE1v1DAQhq0KVLYLP6FSDsAtix17be-BA6zohxSJS6uicrBmnTFNSexgJ2359_UqqyJO9sz7zNh6CPnA6IrRDf8UnlyIzX2Yoocure6mPuKwAsaVptURWTAhaVnxNX1FFrSSumRMsjfkJKV7SvNVy2NyzLjmleQL8vPqDovWu25Cb7EIrggPEFvwRcQ0BJ9yzxe_oMdxz40RyjPoujDskVz55DAWYRpt6PdAEbomNx5z5d-S1y5_Ed8dziW5Pvt2tb0o6-_nl9svdWk5rcZSoODAdxQ0qI0VDrRYW42bnbJWCSuEQ2ACkDVKaqmsrhhYrkDbplIMFF-Sj_PeIYY_E6bR9G2y2HXgMUzJKF7xPCkz-HkGbQwpRXRmiG0P8a9h1Ozlmv_lmlmuOcjN86eHh6Zdj82_6dlmzt8fckgWOpf12Da9YIJrpTO6JOWMtWnEp5cY4m8jFVdrc_Hj1rBtXdc3Xzfmlj8DKombqw</recordid><startdate>199209</startdate><enddate>199209</enddate><creator>Al-Shawaf, Talha</creator><creator>Nolan, Aonghus</creator><creator>Guirgis, Rifky</creator><creator>Harper, Joyce</creator><creator>Santis, Meryl</creator><creator>Craft, Ian</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199209</creationdate><title>The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women</title><author>Al-Shawaf, Talha ; Nolan, Aonghus ; Guirgis, Rifky ; Harper, Joyce ; Santis, Meryl ; Craft, Ian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c302t-4e43a3b0a8a79c4fa845c8e9b7cc74c44fea14ae1d76867c821ac37a8cd271a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Aging - physiology</topic><topic>Biological and medical sciences</topic><topic>Buserelin - therapeutic use</topic><topic>Chorionic Gonadotropin - blood</topic><topic>Chorionic Gonadotropin, beta Subunit, Human</topic><topic>Clomiphene - therapeutic use</topic><topic>Female</topic><topic>Follicle Stimulating Hormone - therapeutic use</topic><topic>gamete intra-Fallopian transfer</topic><topic>Gamete Intrafallopian Transfer</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Menotropins - therapeutic use</topic><topic>older aged women</topic><topic>Oocytes - physiology</topic><topic>ovarian response</topic><topic>Ovary - physiology</topic><topic>Peptide Fragments - blood</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>pregnancy rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al-Shawaf, Talha</creatorcontrib><creatorcontrib>Nolan, Aonghus</creatorcontrib><creatorcontrib>Guirgis, Rifky</creatorcontrib><creatorcontrib>Harper, Joyce</creatorcontrib><creatorcontrib>Santis, Meryl</creatorcontrib><creatorcontrib>Craft, Ian</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al-Shawaf, Talha</au><au>Nolan, Aonghus</au><au>Guirgis, Rifky</au><au>Harper, Joyce</au><au>Santis, Meryl</au><au>Craft, Ian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women</atitle><jtitle>Human reproduction (Oxford)</jtitle><addtitle>Hum Reprod</addtitle><date>1992-09</date><risdate>1992</risdate><volume>7</volume><issue>8</issue><spage>1106</spage><epage>1110</epage><pages>1106-1110</pages><issn>0268-1161</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><notes>1To whom correspondence should be addressed</notes><notes>ark:/67375/HXZ-1CLLLWB9-Z</notes><notes>ArticleID:7.8.1106</notes><notes>istex:E0D92D4ECB42D94495444DB6938B407BAE58A154</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged ≥40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GUT) cycles in women aged ≥40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum β-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if > 10 oocytes were retrieved. If 1—3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4–10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when >10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transferred in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonado-trophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged ≥40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>1383263</pmid><doi>10.1093/oxfordjournals.humrep.a137802</doi><tpages>5</tpages></addata></record> |
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| ispartof | Human reproduction (Oxford), 1992-09, Vol.7 (8), p.1106-1110 |
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| language | eng |
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| source | Oxford University Press:Jisc Collections:Oxford Journal Archive: Access period 2024-2025 |
| subjects | Adult Aging - physiology Biological and medical sciences Buserelin - therapeutic use Chorionic Gonadotropin - blood Chorionic Gonadotropin, beta Subunit, Human Clomiphene - therapeutic use Female Follicle Stimulating Hormone - therapeutic use gamete intra-Fallopian transfer Gamete Intrafallopian Transfer Gynecology. Andrology. Obstetrics Humans Medical sciences Menotropins - therapeutic use older aged women Oocytes - physiology ovarian response Ovary - physiology Peptide Fragments - blood Pregnancy Pregnancy Outcome pregnancy rate |
| title | The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women |
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