THE USE OF A SHARED DONOR OOCYTE PROGRAM TO EVALUATE THE EFFECT OF UTERINE SENESCENCE

Objective: To determine if there is reduced uterine receptivity after age 40 by the comparison of pregnancy rates (PRs) of donor oocyte recipients greater than or equal to 40 years to those under age 40. Setting: In vitro fertilization-ET facility of a university- based practice, Cooper Institute for In Vitro Fertilization. Patients: All patients registering for the shared donor oocyte program from November 1990 to September 1992. Most recipients were in ovarian failure. Interventions: Donors were treated with luteal phase leuprolide acetate (LA) and gonadotropins; recipients were treated with oral E(2) in graduated doses and 50 mg IM daily P. Endometrial thickness was considered in the decision to continue with transfer or to freeze air embryos. Main Outcome Measures: Pregnancy rates per transfer in recipients and live birth rates according to age greater than or equal to 40 or <40. Results: The clinical PR per transfer was 29.2% for the younger women and 25.4% for the older recipients. The live birth rate was 29.2%; for the younger women and 22.4% for the older recipients. Conclusions: These data support the conclusion that, if there is a decline in uterine receptivity for embryo implantation with advancing age, it is at least remediable with hormonal adjustments.