Pratip ChakrabortyInstitute of Reproductive Medicine, India
Title: Female Fertility Clock Closes to Tick around the Age of 43
Objective: To investigate if attempting In Vitro Fertilization (IVF) in women over 40 is of worth.
Materials & Methods: Two hundred and thirty nine women over 40 years of age undergoing IVF were enrolled. Long protocol was used for down-regulation followed by stimulation and IVF-ET. The primary outcome measure was live-birth rate. Secondary outcomes included rates of miscarriage, cycle cancellation, obstetrical complications, and maternal and fetal adverse events.
Results: Clinical pregnancy rates per cycle were 42.85 %, 39.34 %, 34.09 %, 27.27 % and 16.66 % for 40, 41, 42, 43 and 44 years old, respectively. Absolute difference in live birth rate in age 40 - 44 vs control, -15 percentage points; 95 % Confidence Interval (CI) -45 to 15.1, -18.77 percentage points; 95 % CI,(-56.31 to 18.79), -23.77 percentage points; 95 % CI,(-71.31 to 23.81), -25.82 percentage points; 95 % CI, (-77.48 to 25.84) and, - 27.72 percentage points; 95 % CI, (-83.16 to 27.76), respectively. Intra-uterine growth restriction and preterm delivery occurred significantly more frequently in the age group of 42 and above. Only one IVF cycle in patients aged 44 resulted in delivery.
Conclusion: It appears that IVF treatment should be limited to patients not older than 43 years, with adequate ovarian response.
Dr. Pratip Chakraborty is currently leading the Basic Science Unit of Assisted Reproduction Division in Institute of Reproductive Medicine, Kolkata. He is the only Indian International Reviewer for formulation of guidelines of Recurrent Pregnancy loss and Controlled Ovarian Stimulation for IVF/ICSI by Early Pregnancy Guideline Development Group and Reproductive Endocrinology and Ovarian Stimulation Group of European Society of Human Reproduction and Embryology in 2017 and 2019. He is actively involved in using and understanding signaling pathways for the pathogenic mechanism/s underlying complex female reproductive disease/s. His publications in various peer-reviewed journal/s comprise every basic techniques of reproduction. He has over 50 publications that have been cited over 400 times, and his publication h-index is 8. He has been serving as an editorial board member of several reputed journals.