Treatment of infertile couples with advanced maternal age (AMA) is a growing challenge in Assisted Reproductive Technology (ART). In Vitro Fertilization (IVF) outcome using fresh embryos is significantly low as compared with young female patients. The results of frozen-thawed embryo (FET) cycles in older patients has not been thoroughly investigated so far. The aim of this study is report our experience in FET cycles in AMA IVF patients. A retrospective case-control study. A retrospective summary of all patient files who had FET cycles in which embryos were retrieved when the patient was ≥ 40 years of age. Each cycle was matched with the consecutive FET cycle performed in our unit in a patient aged ≤ 35 years. FET cycles in which a single embryo was thawed were excluded from analysis. 76 women in the study group underwent 100 FET cycles, and 96 women underwent 100 FET cycles in the control group. The mean age of study patients was 41.8±1.7 years, and 29.4 ± 3.4 in the control group. Pregnancy and delivery rates in the corresponding ovarian pick-up cycle were 13 and 5.4% in the study group compared with 30 and 24% in the control group (P < 0.001). The mean number of transferred embryos in FET cycle was 3.05 and 2.5 in the study and control group, respectively (P<0.0001). Top quality embryos were transferred in 64 and 66% of FET cycles in the study and control group, respectively (NS). Pregnancy and delivery rates in FET cycle were 5 and 3% in the AMA group compared with 33 and 27% in the control group (P<0.000001). ART using frozen-thawed embryos in AMA patients is inefficient. Since higher success rates were reported when multiple (> 4) embryos were transferred, and considering the low risk for a high-order multiple pregnancies in this age group, transfer of many fresh embryos appears to be a safe and relatively efficient strategy rather than embryo cryopreservation for later transfer.