Advanced maternal age and assisted reproductive technologies in an Irish population

Abstract

In recent decades the amount of women over 40 seeking assisted reproductive technology (ART) interventions in order to become pregnant has dramatically increased, both in Ireland and worldwide. This is due to an increase in the average age at which women are choosing to have their first child while additionally, many couples are choosing to have a second family later in life. However, as with natural conception, ART success rates decrease with maternal age. In the present study, we perform a 16 year retrospective analysis on our clinical data of women between 40 and 45 years of age, who have undergone ART at a tertiary referral ART clinic. The percentage of patients in this age group was analysed over time, in order to determine follicle recruitment, % oocyte yield, embryonic quality, positive hCG (pregnancy rate), clinical pregnancy rate and rate of preclinical pregnancy loss. Results from our clinic show that women greater than 43 years of age have a significantly reduced reproductive potential compared to women in the 40 to 42 years age group. Woman in the 43-45 age group showed reduced fertilization rates (53.73% versus 58.82%), reduced positive hCG rates (11.51% versus 19.03%) and clinical pregnancy rates (5.04% versus 12.52%) and increased rates of preclinical pregnancy loss (56.23% versus 34.23%), compared to women in the 40-42 age group. With the age at which couples are choosing to have children constantly increasing, novel ART treatment strategies need to be developed.