IMR Press / CEOG / Volume 40 / Issue 1 / pii/1630388018480-2044945994

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Origianal Research
Embryo apoptosis may be a significant contributing factor in addition to aneuploidy inhibiting live deliveries once a woman reaches age 45
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1 Cooper Medical School of Rowan University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, New Jersey
2 The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ (USA)
Clin. Exp. Obstet. Gynecol. 2013, 40(1), 22–23;
Published: 10 March 2013
Abstract

Purpose: To determine the relative role of aneuploidy vs embryo apoptosis as the etiologic factor of poor pregnancy rates with advancing age. Materials and Methods: A retrospective review of chemical vs clinical vs live delivery pregnancy rates in women aged 40-42, 43-45, and ≥ 45 years is reported. The data were further stratified according to oocyte reserve based on day 3 serum follicle-stimulating hormone (FSH) ≤ 11 mIU/ml vs >12 mIU/ml. Results: For women aged 40-42 years there were no differences in live delivery pregnancy rates in women with normal vs decreased egg reserve (DOR). There were no differences in live delivery pregnancy rates in women aged 40-42 years vs 43-44 years with normal oocyte reserve; however despite no differences in clinical pregnancy rates in women aged 43-44 years with normal vs DOR, the live delivery pregnancy rates were markedly lower in the group with DOR. In contrast, there were very low chemical pregnancy rates in women aged ≥ 45 years. Conclusions: As seen in younger women, there does not appear to be any increased risk of meiosis errors in women aged 40-42 years with DOR compared to women of the same age with normal reserve. Low pregnancy rates in women aged 43-44 years with DOR is related to meiosis errors. In contrast the very low chemical pregnancy rates found in women aged ≥ 45 years despite embryo transfer (ET) suggest embryo apoptosis is mostly responsible for poor pregnancy rates in this very advanced reproductive age group.
Keywords
Apoptosis
Meiosis errors
Reproductive aging
In vitro fertilization
Pregnancy rates
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