Age and Fertility

Abstract

Due to the trend of postponing childbearing, more and more patients aged 40 and above consult fertility services. The general aim of the work presented in this thesis was to investigate the influence of age on ART outcomes in order to improve counseling of patients. The research in this thesis is focussed on two domains. In the first part of this thesis we investigated the influence of age after IUI and IVF/ICSI. Our first study corroborated the impact of age on donor insemination outcome. In the second study of this first part the impact of age in ICSI treatments was examined as well.
In the second part of this thesis we tried to discover how to counsel patients aged 40 and above. In the first study we performed an observational study in women aged 40 and above and we analyzed the outcome in a consecutive cohort. It seemed that only 10% of patients in this age category achieved a delivery of a child that was their own genetic product, while 1% conceived spontaneously. More than one third of the patients never started treatment for different reasons. In the second study of this part we tried to analyze which treatment of choice should be offered to patients aged 40 and above, i.e. IUI or IVF/ICSI. A crude CDR of 22% was seen after one IVF/ICSI cycle. A crude CDR of 24% was seen after six IUI cycles. Since time-to pregnancy is an important argument in these patients, we can defend, at this moment, the choice to start immediately with an ICSI treatment since a single cycle of ICSI will achieve the same success as a much longer period with IUI.

Date of Award	2 Jun 2015
Original language	English
Awarding Institution	Vrije Universiteit Brussel
Supervisor	Herman Tournaye (Promotor), Michel Camus (Co-promotor), J. Gerris (Jury), Fulco van der Veen (Jury), Willem Ombelet (Jury), Hilde Van De Velde (Jury), Brigitte Velkeniers-Hoebanckx (Jury) & Christiaan Van Schravendijk (Jury)