The effects of prognostic factors on pregnancy success among women 39 years or older having intracytoplasmic sperm injection

Abstract

Amac: Bu calismada 39 yas ve uzeri infertil kadin hastalarda yasin, prognostik faktorler ile ureme potansiyeli uzerindeki sonuclarinin degerlendirilmesi amaclandi. Gerec ve Yontemler: Ileri yasta (≥39 yil) 107 infertil kadin hasta retrospektif olarak degerlendirildi. Hastalarin insan koryonik gonadotropin (hCG) uygulanan gunde olculen endometrium kalinligi, toplam kullanilan gonadotropin dozu, stimulasyon sureleri, 3. gun bazal follikul stimule edici hormon (FSH) ile bazal estradiol (E2) duzeyleri, toplanan oosit ile fertilize oosit sayilari ve transfer edilen embriyo sayilari kaydedildi. Bu parametrelerin gebelik basarisi uzerine etkileri degerlendirildi. Hastalar 39 yas (n=47), 40-41 yas (n=37) ve 42 ve uzeri yas (n=23) olmak uzere uc yas grubu karsilastirildi. Bulgular: Canli dogum orani 39 yas grubunda %23,2 ve 40-41 yas grubunda %14,7 olarak gozlendi. Kirk iki ve uzeri yas grubunda ise canli dogum gorulmedi. Bu calismanin sonuclari yasin, toplanan oosit ve fertilize oosit sayisinin gebelik gelisimi uzerine etkisinin oldugunu gosterdi. Sonuc: Gebelik orani 39 yasindan sonra hizli bir sekilde dusmektedir; intrasitoplazmik sperm enjeksiyonu sonrasi, hastalarda 39 yasindan itibaren gebelik basarisi 3 yil sonra 9 kat azalmistir. Ileri maternal yasin, gebelik ve canli dogum oranlari uzerindeki olumsuz etkisi klinik calismamizda da gozlenmistir. J Turk Soc Obstet Gynecol 2014;2:78-83 Anahtar Kelimeler: Kadin, yas, gebelik orani Objective: The objective of this study is to investigate the effect of age on the prognostic factors and fertilization potential of infertile women who are 39 years or older. Material and Methods: 107 patients with advanced maternal age (≥39 years) were included in this retrospective study. The endometrial thickness on the day of human chorionic gonadotropin (hCG), total dose of gonadotropin used, duration of stimulation, levels of day-3 basal follicule stimulating hormone (FSH) and basal estradiol (E2), number of retrieved oocytes and fertilized oocytes, and number of embryos transferred were recorded. These parameters were used to evaluate their effects on the success of pregnancy. Patients were categorized into three age groups: 39 years old (n=47), 40-41 years old (n=37), and ≥ 42 years old (n=23) and age groups were compared. Results: The rate of live birth was %23.2 in 39 years and %14.7 in 40-41 years. No live birth in 42 years or older patients was recorded. The results revealed that that the age, number of retrieved oocytes and fertilized oocytes predict the success rate of pregnancy. Conclusion: Pregnancy rate dramatically decreased after the age of 39; the success of pregnancy after the intracytoplasmic sperm injection decreases 9 times, three years later starting age of 39. The negative effect of advanced maternal age on pregnancy and live birth rates was observed in our clinical study, as well. J Turk Soc Obstet Gynecol 2014;2:78-83