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Tan TY, Lau SK, Loh SF, Tan HH
Correspondence: Dr Matthew Lau Sie Kuei, matthew.lau.sk@kkh.com.sg
ABSTRACT
INTRODUCTION Fertility in women declines with increasing age. With the deferment of marriage and childbearing, couples are turning to assisted reproductive technology to counteract this decline. We aimed to evaluate the results of in vitrofertilisation (IVF)/intracytoplasmic sperm injection (ICSI) in women of different age groups, and highlight the cost-effectiveness of IVF treatment in these groups while assessing its implications on the national healthcare provision model.
METHODS Retrospective analysis of 3,412 stimulated IVF/ICSI cycles in a hospital-based IVF centre was performed from January 2008 to December 2010. Patients were stratified into seven age groups: < 30 years; 30–35 years; 36–37 years; 38 years; 39 years; 40–44 years; and ≥ 45 years.
RESULTS Age had a significant effect on the number of cycles leading to embryo transfer (p < 0.001). The number of oocytes retrieved decreased across the various age groups (p < 0.001) and was the highest among women aged < 30 (mean 18.5 ± 10.3) years. With increasing age, there was a trend toward a lower fertilisation rate. Age also had a significant effect on the rates of clinical pregnancy, live birth and multiple pregnancies (p < 0.001).
CONCLUSION Patients aged < 30 years had the best IVF outcomes, refl ecting optimal reproductive capacity. Age-related decline in fertility starts after 30 years. Women opting for IVF should be counselled about age-specific success rates while taking into account individual risk factors.
Keywords: clinical pregnancy rate, female ageing, in vitrofertilisation outcome, live birth rate, miscarriage rate
Singapore Med J 2014; 55(6): 305-309; http://dx.doi.org/10.11622/smedj.2014081
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