Fertility treatment in the forty and older woman

Purpose: To determine the outcomes and logical progression of fertility treatment in women forty years and older using their own oocytes. Methods: This was a retrospective study in which 401 completed treatment cycles in 152 women aged forty and older were reviewed. Results: Assisted reproductive technology (ART) cycles (n = 58) were reviewed, comprising both in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Intrauterine insemination (IUI) cycles (n = 343) were reviewed, consisting of 38 unstimulated natural cycle-IUI (NC-IUI), 194 clomiphene citrate-IUI (CC-IUI), and 111 injectable gonadotropins-IUI (INJ-IUI) cycles. The live birth rate of 15.5% for ART cycles was significantly higher than the live birth rate of 3.2 % seen for all IUI cycles (p = 0.0007). There were no differences among treatment groups in spontaneous abortion, preterm delivery, or ectopic pregnancy rates. Conclusions: For women ≥40 years of age who wish to use their own eggs, ART offers the best chances for conception and delivery.