OUTCOME OF ICSI IN PATIENTS AGED 35 YEARS AND OVER

Objectives: Adequate ovarian response is essential for successful assisted reproduction treatment in ICSI patients, and particularly among older infertile women. This study amied to evaluate the ovarian response and outcome in ICSI patients aged 35 years and over undergoing ICSI cycles from July 2005 through December 2006 ill the assisted reproductive technology (ART) unit, Al-Azhar University. The study included 180 patients classified into two groups; those aged 35 to 40 years (86%) considered to be the first group; and 26 patients aged more thn 40 years (14%) are considered the second group. Oocytcs retrieved, embryos obtained, and pregnancy outcome were the main outcome measures. Chi-squarc and t lest were used as appropriate. Of the studied women, 158 (88%) rcahed the oocyle retrieval stage (134 in the first group and 24 in the second group). The mean number of oocytcs aspirated per patient was 6.7±4.0 and 3.4±2.0 in the first and second groups respectively with statistically significant difference (p < .0001). Excluding negative fertilization patients, the mean number of obtained embryos in the first group (n=II4) and second group (n=14) was 3.7±2.5 and 2.5±I2.7 (p = 0.04). The pregnancy rate, however was 15% in those aged 35 to 40 years and 21 % in those > 40 years, but with statistically significant difference.
Conclusion: This study showed that the number of oocytcs retrieved and oocytcs obtained to decrease by increasing age in ICSI patients aged 35 years and over. However, the pregnancy rale was slighlly higher in older patients suggesting personal variations to play a role. Other studies with large number of patients and from different centers are needed to confirm these results.