This Article  • References  • Full text PDF  • Correction  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (108)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

An Extended Clinical Trial of Oocyte Donation to Women of Advanced Reproductive Age

Mark V. Sauer, MD; Richard J. Paulson, MD; Rogerio A. Lobo, MD

JAMA. 1992;268(10):1275-1279.

Abstract
Objective.
—To evaluate the effect of age on pregnancy success rates in functionally agonadal women undergoing oocyte donation.

Design.
—A prospective study of 100 consecutive patients using oocyte donation for the treatment of infertility.

Patients.
—Women aged 40 years and above requesting oocyte donation (N=104) were required to undergo medical, reproductive, and psychological screening. Suitable candidates (n=65) were matched with an oocyte donor whose cycle was synchronized with that of the potential recipient, prior to the donor's undertaking ovarian hyperstimulation and transvaginal ultrasound—directed follicle aspiration. Outcomes were compared with those of two groups undergoing therapy at the same time: (1) women below 40 years of age undergoing oocyte donation for premature ovarian failure (n=35) and (2) women 40 years of age and above undergoing standard in vitro fertilization and embryo transfer using their own oocytes (n=57).

Main Outcome Measures.
—Embryo implantation and pregnancy rates.

Setting.
—The in vitro fertilization program of the University of Southern California and the California Medical Center, Los Angeles.

Results.
—Improved outcomes were observed with regard to fertilization rates in vitro, number of embryos transferred, embryo implantation rate, clinical pregnancy rates, and ongoing or successfully completed pregnancy rates when women undergoing oocyte donation regardless of age were compared with women 40 years of age and above using their own oocytes. No age-related decline in fertility was demonstrable when oocyte donation was used, with a mean age of 44.3±3.1 years for those successfully conceiving (range, 40 to 52 years). Perinatal outcomes (n=27) were generally uncomplicated, with a mean gestational age at delivery of 38.4±2.1 weeks (range, 34 to 42 weeks), although multiple births occurred in 24.1% of cases.

Conclusions.
—The age-related decline in female fertility may be reversed in couples electing to use donated oocytes from a younger woman, and women of advanced reproductive age may conceive, carry, and give birth to infants with success rates similar to those of their younger counterparts using assisted reproductive methods.

(JAMA. 1992;268:1275-1279)

Author Affiliations
From the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles.

Footnotes
Reprint requests to Women's Hospital, 1240 N Mission Rd, Room L946, Los Angeles, CA 90033 (Dr Sauer).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Primary Ovarian Insufficiency
Nelson
NEJM 2009;360:606-614.
FULL TEXT  

Assessment of the proliferative status of epithelial cell types in the endometrium of young and menopausal transition women
Niklaus et al.
Hum Reprod 2007;22:1778-1788.
ABSTRACT | FULL TEXT  

Implantation-Dependent Expression of Trophinin by Maternal Fallopian Tube Epithelia during Tubal Pregnancies: Possible Role of Human Chorionic Gonadotrophin on Ectopic Pregnancy
Nakayama et al.
Am. J. Pathol. 2003;163:2211-2219.
ABSTRACT | FULL TEXT  

Early pregnancy loss following assisted reproductive technology treatment
Winter et al.
Hum Reprod 2002;17:3220-3223.
ABSTRACT | FULL TEXT  

Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age
Paulson et al.
JAMA 2002;288:2320-2323.
ABSTRACT | FULL TEXT  

Features associated with reproductive ageing in female rhesus monkeys
Schramm et al.
Hum Reprod 2002;17:1597-1603.
ABSTRACT | FULL TEXT  

Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycles
Pena et al.
Hum Reprod 2002;17:83-87.
ABSTRACT | FULL TEXT  

Implantation and the Survival of Early Pregnancy
Norwitz et al.
NEJM 2001;345:1400-1408.
FULL TEXT  

Perifollicular vascularity as a potential variable affecting outcome in stimulated intrauterine insemination treatment cycles: a study using transvaginal power Doppler
Bhal et al.
Hum Reprod 2001;16:1682-1689.
ABSTRACT | FULL TEXT  

No evidence of increased uterine vascular impedance with patient ageing following IVF
Check et al.
Hum Reprod 2000;15:1679-1684.
ABSTRACT | FULL TEXT  

Donor age is paramount to success in oocyte donation
Cohen et al.
Hum Reprod 1999;14:2755-2758.
ABSTRACT | FULL TEXT  

A macaque model for studying mechanisms controlling oocyte development and maturation in human and non-human primates
Schramm and Bavister
Hum Reprod 1999;14:2544-2555.
ABSTRACT | FULL TEXT  

Colour Doppler indices of follicular blood flow as predictors of pregnancy after in-vitro fertilization and embryo transfer
Coulam et al.
Hum Reprod 1999;14:1979-1982.
ABSTRACT | FULL TEXT  

Pharmacokinetics of natural progesterone administered in the form of a vaginal tablet
Levy et al.
Hum Reprod 1999;14:606-610.
ABSTRACT | FULL TEXT  

The New Frontier of Reproductive Age
Quigley
JAMA 1992;268:1320-1321.
ABSTRACT