Good Birth Outcomes Possible in Women Over 50.

RANCHO MIRAGE, CALIF. -- Carefully screened women aged 50 and older who become pregnant through in vitro fertilization stand a good chance of having a term delivery with favorable maternal and neonatal outcomes, Dr. Robert Boostanfar reported at the annual meeting of the Pacific Coast Reproductive Society.

But they are also at a significantly increased risk of developing preeclampsia and gestational diabetes and of undergoing operative delivery compared with younger women, said Dr. Boostanfar of the division of reproductive endocrinology and infertility at the University of Southern California, Los Angeles.

Dr. Boostanfar based his comments on the results of a study he conducted that included the single largest cohort of women completing pregnancies in their sixth decade of life.

He and his associates retrospectively reviewed outcomes in 72 postmenopausal women aged 50-63 who underwent in vitro fertilization (IVF) using donor oocytes at his institution between 1991 and 2000.

Before initiating therapy, all patients had a thorough medical screening, which included a complete physical and pelvic exam, mammography and chest x-ray, electrocardiogram and treadmill stress test, Pap smear, chemistry panel, complete blood count, lipid panel, TSH, and an infectious disease serology. All patients also underwent psychological screening and an endometrial biopsy to assess endometrial response to exogenous estradiol and progesterone supplementation.

Among the study participants, a total of 83 aspirations resulted in 115 embryo transfers, leading to 56 clinical pregnancies for a total pregnancy rate of 49%.

There were 43 viable pregnancies in 40 women, and 3 women carried two consecutive pregnancies. The live birth rate was 38%, with a multiple ...