Cumulative live birth rates with autologous oocytes plateau with fewer number of cycles for each year of age > 42

Abstract

Abstract Objective To disaggregate the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) age category of “ > 42” and compare age-stratified cumulative live birth rates (CLBR) > 42 years old. Design Retrospective cohort study of autologous linked ART cycles. Setting United States (US) National ART Database. Patient(s) Women > 42 years old without a history of prior ART cycles who underwent ART between 2014–2020 as reported to the SART CORS database. Intervention(s) Disaggregate the SART CORS age category of “ > 42” into age-stratified cumulative live birth rates (CLBR). Main Outcome Measure(s) Age-stratified cumulative live birth rates (CLBR) for women ≥ 43 years old. Results Between 2014–2020, 24,650 women > 42 years old without history of prior ART underwent 58,132 cycles, resulting in 1,982 live births. Women ages 43, 44, 45, 46, 47, 48, 49, ≥ 50 achieved maximal CLBR of 9.7%, 8.6%, 5.0%, 3.6%, 2.5%, 1.5%, 2.7%, 1.3%, respectively. CLBR for women between 43–45 were significantly higher compared to those 46 and older (p 42. Conclusions While CLBR of autologous cycles from women 42 or younger generally plateau by cycle number 5, age-stratified cycles from women > 42 plateau after fewer cycles to maximize CLBR. Patient and physician expectations for maximum CLBR beyond 42 may be practically based on fewer planned cycles before reaching an age-specific CLBR plateau than may have been previously expected.

Keywords

• Autologous oocytes
• Cumulative live birth rates
• Age > 42
• Advanced reproductive age women
• SART CORS