Improved pregnancy outcome for women with decreased ovarian oocyte reserve and advanced reproductive age by performing in vitro fertilization-embryo transfer.

Objective: To compare the pregnancy rates with IVF-ET vs non-assisted reproductive technology in women of more advanced reproductive age with decreased egg reserve as manifested by elevated day 3 serum FSH. Methods: A retrospective evaluation was made in women aged ≥38 with a day 3 serum FSH of a 15 mIU/ml with ≥ 1 year of infertility. Another inclusion criterion was three cycles (unless a pregnancy occurred before that time) of either IVF-ET or non-assisted reproductive therapy which as a minimum included luteal phase support with progesterone. Results: The clinical pregnancy rates in three cycles for non-IVF were 11.7% vs 27.2% for IVF. Delivery rates were 2.9% vs 15.1%. For ages 40-42 the clinical pregnancy rates were 37.5% vs 0.0% (p =.02). Conclusions: Live deliveries are possible in women ≥ age 38 with marked decreased egg reserve. In vitro fertilization is more effective than non-IVF when follicle stimulation with gonadotropins is mild.