The effect on pregnancy and multiples of transferring 1-3 embryos in women at least 40years old.

Abstract

PURPOSE "CAPSULE" IS MANDATORY. PLEASE PROVIDE.SINGLE EMRBYO TRANSFER (SET) IN WOMEN ≥40 YEARS OLD APPEARS TO LOWER THE CHANCE OF A PREGNANCY. HOWEVER, IT MINIMIZES THE RISK OF MULTIPLE PREGNANCIES EVEN IN WOMEN OF ADVANCED MATERNAL AGE. THEREFORE, WOMEN 40 YEARS OF AGE OR OLDER SHOULD BE OFFERED (SET).: This study was performed to investigate the multiple pregnancies and live birth rates when 1-3 embryos are transferred at this age in women at least 40years of age. A retrospective analysis of data which included 631 women aged 40 to 46years, who underwent 901cycles of IVF, from August 2010 to June 2012 was undertaken. These women underwent embryo transfer of 1-3 non-donor fresh embryo(s). Results suggested that the average pregnancy rate when up to three embryos were transferred was 25% for women 40years old, 20% for women 41years old, 16% for women 42years old, 17% for women 43years old, 8% for women 44years old, 6% for women 45years old, and 0% for women 46years old. No live births occurred in women treated after their 44th birthday, and only patients younger than 42years of age receiving double embryo transfer had a live birth of twins. Live birth rates increased as more embryos were transferred for 40- and 42-year-old subjects (p = 0.01 and 0.05, respectively). From these results, it was concluded that SET in women ≥40years old appears to lower the chance of a pregnancy. However, it minimizes the risk of multiple pregnancies even in women of advanced maternal age. Women 40years of age or older should be offered single-embryo transfer. Further studies are needed to determine risk of multiple pregnancies in women 42years of age or older when few embryos are transferred. Decisions on the number of embryos to transfer should be on a case by case basis, in discussion with the patient.