Does Age Play a Part in Determining Dosage of Gonadotropins?

Q&A with the Experts

2

Does Age Play a Part in Determining Dosage of GonadotropinsQ: Are older women better or worse candidates for using lower amounts of ovulation stimulation drugs (gonadotropins)?

A: This question can’t be answered with a simple “better” or “worse”. We must first decide if we are looking at a group of women with diminished ovarian reserve or simply older women. What about younger women with diminished ovarian reserve? How do you define older? How do you define diminished ovarian reserve? The answer also depends on the patient’s diagnosis. There have been several studies looking at the effectiveness of minimal stimulation IVF on older women. A randomized clinical trial in women over 38 comparing minimal stimulation cycles to standard stimulation found a reduced number of embryos developed in the lower dose cycles. Embryo biopsy at the 8-cell stage revealed an equal number of genetically normal embryos. A recent meta-analysis comparing mild stimulation with conventional IVF failed to find a difference in cumulative live birth rate, ongoing pregnancy, or ovarianhyperstimulation syndrome. One recent retrospective study found that the modified natural cycle was less cost effective and had a lower cumulative live birth rate in comparison with conventional IVF. A prospective randomized trial combining clomiphene with gonadotropin found a higher cancellation rate and lower ongoing pregnancy rate when clomiphene was utilized. With the advent of embryo screening with PGS and mitochondrial screening, we can achieve superior pregnancy rates sooner and more cost-effectively with a reduced risk of miscarriage. While the evidence is strong that higher gonadotropin doses will not likely improve cycle outcome,the benefit of minimal stimulation is unproven and age does not seem to be a factor.

Answered by Dr. Perloe at Georgia Reproductive Specialists

Image credit: Josef Seibel

03/05/2016 | by Q&A with the Experts | Categories: Infertility, Infertility Q&A with Experts | 2 Comments



2 Responses to Does Age Play a Part in Determining Dosage of Gonadotropins?

  1. Karen Davis says:

    I am 52 years old and in great shape. What is the percentage of carrying a healthy fetus with an egg donor?

Leave a Reply

Your email address will not be published. Required fields are marked *

Back to Top ↑

Content created by Creating a Family. And remember, there are no guarantees in adoption or infertility treatment. The information provided or referenced on this website should be used only as part of an overall plan to help educate you about the joys and challenges of adopting a child or dealing with infertility. Although the following seems obvious, our attorney insists that we tell you specifically that the information provided on this site may not be appropriate or applicable to you, and despite our best efforts, it may contain errors or important omissions. You should rely only upon the professionals you employ to assist you directly with your individual circumstances. CREATING A FAMILY DOES NOT WARRANT THE INFORMATION OR MATERIALS contained or referenced on this website. CREATING A FAMILY EXPRESSLY DISCLAIMS LIABILITY FOR ERRORS or omissions in this information and materials and PROVIDES NO WARRANTY OF ANY KIND, implied, express or statutory. IN NO EVENT WILL CREATING A FAMILY BE LIABLE FOR ANY DAMAGES, including without limitation direct or indirect, special, incidental, or consequential damages, losses or expenses arising out of or in connection with the use of the information or materials, EVEN IF CREATING A FAMILY OR ITS AGENTS ARE NEGLIGENT AND/OR ARE ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.