Blastocyst transfer in women over 35 years of age not achieve pregnancy: experience at 11,000 feet above sea level

Abstract

To determine clinical pregnancy rate (CPR) associated with embryo transfer at cleavage or blastocyst stage in women over 35 years in intracytoplasmic sperm injection (ICSI) procedures performed at 11,000 feet above sea level (f.a.s.l.). Retrospective study. In our center, located at 11,000 f.a.s.l., we reviewed clinical data from all ICSI patients. CPR was defined by presence of gestacional sac and embryo with heart beats. Statistical differences were analyzed by Fisher's exact test. Patients under 35 years old with embryo transfer at cleavage stage achieved a CPR of 34.6%, while blastocyst transfer, a CPR of 44.6%. Patients over 35 years old with embryo transfer at cleavage stage achieved a CPR similar to those younger than 35 years (25.8%). In contrast, blastocyst transfer fails clinical pregnancy. Evaluating outcomes in patients over the age of 35 with good ovarian reserve, selecting only those with antral follicle count greater than 6 shows the same trend.Tabled 1Outcome by stage at embryo transfer in women younger or older 35 yearsClinical pregnancyNegativeTotalp valueOVERALL35 years old or youngerCleavage18 (34.6%)34 (65.4%)52p = 0.467Blastocyst12 (44.4%)15 (55.6%)27Older 35 years oldCleavage17 (25.8%)49 (74.2%)66p = 0.059Blastocyst0 (0.0%)12 (100.0%)12WOMEN WITH GOOD OVARIAN RESERVE35 years old or youngerCleavage15 (34.1%)29 (65.9%)44p = 0.454Blastocyst12 (44.4%)15 (55.6%)27Older 35 years oldCleavage13 (40.6%)19 (59.4%)32p = 0.018Blastocyst0 (0.0%)10 (100.0%)10 Open table in a new tab 3 patients over 35 years old achieved thawed blastocyst transfer and 2 got clinical pregnancy. Blastocyst transfer in women older than 35 years old fails clinical pregnancy while the transfer at cleavage stage achieved a CPR similar to that observed under age of 35 years. Blastocysts from patients over 35 years old might not have adaptability to the stimulated endometrium.