Science China Life Sciences

, Volume 55, Issue 8, pp 694–698 | Cite as

Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET)

  • JunHao Yan
  • KeLiang Wu
  • Rong Tang
  • LingLing Ding
  • Zi-Jiang ChenEmail author
Open Access
Research Paper Special Topic


This is a retrospective, observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). 11830 IVF-ET cycles from 10268 women were included. Four groups of different maternal age periods were compared. The groups were 21–30 years old group (4549 cycles), 31–35 years old group (4424 cycles), 36–40 years old group (2429 cycles), and over 40 years old group (428 cycles). The mean starting dose of Gn and mean total dose of Gn in each cycle were significantly higher (P<0.01), while the mean retrieved oocyte number was significantly lower (P<0.01) in groups of higher maternal age period than those in each of the lower groups. The biochemical pregnancy rate and the clinical pregnancy rate were significantly lower (P<0.01), while the miscarriage rate was significantly higher (P<0.01) in groups of higher maternal age period than those in the lower groups. No difference was found in two-pronuclear zygotes (2PN) rate and good quality embryo rate among different groups. Birth defect rate was also comparable in the born babies in different groups. In the group with patients’ age over 40 years old, the pregnancy rate was 26.87%, the clinical pregnancy rate was 19.39%, while the miscarriage rate after clinical pregnancy was 36.14%. To draw the conclusion, patients with higher maternal age had worse IVF outcomes. In women of fertile age, patients between 20 and 30 years old have the best IVF outcomes. Patients over 40 years old have poor IVF outcome and high miscarriage rate, which suggested the necessity of preimplantation genetic screening (PGS).


in vitro fertilization outcome pregnancy rate miscarriage rate birth defect maternal age 


  1. 1.
    Gnoth C, Maxrath B, Skonieczny T, et al. Final ART success rates: a 10 years survey. Hum Reprod, 2011, 26: 2239–2246PubMedCrossRefGoogle Scholar
  2. 2.
    de Mouzon J, Goossens V, Bhattacharya S, et al. Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE. Hum Reprod, 2010, 25: 1851–1862PubMedCrossRefGoogle Scholar
  3. 3.
    Balasch J. Ageing and infertility: an overview. Gynecol Endocrinol, 2010, 26: 855–860PubMedCrossRefGoogle Scholar
  4. 4.
    Tatone C. Oocyte senescence: a firm link to age-related female subfertility. Gynecol Endocrinol, 2008, 24: 59–63PubMedCrossRefGoogle Scholar
  5. 5.
    Hassold T, Chen N, Funkhouser J, et al. A cytogenetic study of 1000 spontaneous abortions. Ann Hum Genet, 1980, 44: 151–178PubMedCrossRefGoogle Scholar
  6. 6.
    Thum M Y, Abdalla H I, Taylor D. Relationship between women’s age and basal follicle-stimulating hormone levels with aneuploidy risk in in vitro fertilization treatment. Fertil Steril, 2008, 90: 315–321PubMedCrossRefGoogle Scholar
  7. 7.
    Yan J, Huang G, Sun Y, et al. Birth defects after assisted reproductive technologies in China: analysis of 15,405 offspring in seven centers (2004 to 2008). Fertil Steril, 2011, 95: 458–460PubMedCrossRefGoogle Scholar
  8. 8.
    Hourvitz A, Machtinger R, Maman E, et al. Assisted reproduction in women over 40 years of age: how old is too old? Reprod Biomed Online, 2009, 19: 599–603PubMedCrossRefGoogle Scholar
  9. 9.
    Griffiths A, Dyer S M, Lord S J, et al. A cost-effectiveness analysis of in-vitro fertilization by maternal age and number of treatment attempts. Hum Reprod, 2010, 25: 924–931PubMedCrossRefGoogle Scholar
  10. 10.
    Vincent-Rohfritsch A, Le Ray C, Anselem O, et al. Pregnancy in women aged 43 years or older: Maternal and perinatal risks. J Gynecol Obstet Biol Reprod (Paris), 2012 (in press)Google Scholar
  11. 11.
    Liu K, Case A. Advanced reproductive age and fertility. J Obstet Gynaecol Can, 2011, 33: 1165–1175PubMedGoogle Scholar
  12. 12.
    Sandalinas M, Sadowy S, Alikani M, et al. Developmental ability of chromosomally abnormal human embryos to develop to the blastocyst stage. Hum Reprod, 2001, 16: 1954–1958PubMedCrossRefGoogle Scholar
  13. 13.
    Jansen R P. Spontaneous abortion incidence in the treatment of infertility. Am J Obstet Gynecol, 1982, 143: 451–473PubMedGoogle Scholar
  14. 14.
    Hakim R B, Gray R H, Zacur H. Infertility and early pregnancy loss. Am J Obstet Gynecol, 1995, 172: 1510–1517PubMedCrossRefGoogle Scholar
  15. 15.
    Liu H C, Jones G S, Jones H W Jr., et al. Mechanisms and factors of early pregnancy wastage in in vitro fertilization-embryo transfer patients. Fertil Steril, 1988, 50: 95–101PubMedGoogle Scholar
  16. 16.
    Risch H A, Weiss N S, Clarke E A, et al. Risk factors for spontaneous abortion and its recurrence. Am J Epidemiol, 1988, 128: 420–430PubMedGoogle Scholar
  17. 17.
    Edmonds D K, Lindsay K S, Miller J F, et al. Early embryonic mortality in women. Fertil Steril, 1982, 38: 447–453PubMedGoogle Scholar
  18. 18.
    Miller J F, Williamson E, Glue J, et al. Fetal loss after implantation. A prospective study. Lancet, 1980, 2: 554–556PubMedCrossRefGoogle Scholar
  19. 19.
    Molo M W, Kelly M, Balos R, et al. Incidence of fetal loss in infertility patients after detection of fetal heart activity with early transvaginal ultrasound. J Reprod Med, 1993, 38: 804–806PubMedGoogle Scholar
  20. 20.
    Nybo Andersen A M, Wohlfahrt J, Christens P, et al. Maternal age and fetal loss: population based register linkage study. BMJ, 2000, 320: 1708–1712PubMedCrossRefGoogle Scholar
  21. 21.
    Cramer D W, Wise L A. The epidemiology of recurrent pregnancy loss. Semin Reprod Med, 2000, 18: 331–339PubMedCrossRefGoogle Scholar
  22. 22.
    Fedorcsak P, Dale P O, Storeng R, et al. Impact of overweight and underweight on assisted reproduction treatment. Hum Reprod, 2004, 19: 2523–2528PubMedCrossRefGoogle Scholar
  23. 23.
    Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril, 2002, 77: 1148–1155PubMedCrossRefGoogle Scholar
  24. 24.
    Garcia-Enguidanos A, Calle M E, Valero J, et al. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol, 2002, 102: 111–119PubMedCrossRefGoogle Scholar
  25. 25.
    Milan M, Cobo A C, Rodrigo L, et al. Redefining advanced maternal age as an indication for preimplantation genetic screening. Reprod Biomed Online, 2010, 21: 649–657PubMedCrossRefGoogle Scholar
  26. 26.
    Mastenbroek S, Twisk M, van der Veen F, et al. Preimplantation genetic screening: a systematic review and meta-analysis of RCTs. Hum Reprod Update, 2011, 17: 454–466PubMedCrossRefGoogle Scholar
  27. 27.
    Traversa M V, Marshall J, McArthur S, et al. The genetic screening of preimplantation embryos by comparative genomic hybridisation. Reprod Biol, 2011, 11: 51–60PubMedGoogle Scholar
  28. 28.
    Chang L J, Chen S U, Tsai Y Y, et al. An update of preimplantation genetic diagnosis in gene diseases, chromosomal translocation, and aneuploidy screening. Clin Exp Reprod Med, 2011, 38: 126–134PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Geraedts J, Montag M, Magli M C, et al. Polar body array CGH for prediction of the status of the corresponding oocyte. Part I: clinical results. Hum Reprod, 2011, 26: 3173–3180PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Gutierrez-Mateo C, Colls P, Sanchez-Garcia J, et al. Validation of microarray comparative genomic hybridization for comprehensive chromosome analysis of embryos. Fertil Steril, 2011, 95: 953–958PubMedCrossRefGoogle Scholar

Copyright information

© The Author(s) 2012

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • JunHao Yan
    • 1
  • KeLiang Wu
    • 1
  • Rong Tang
    • 1
  • LingLing Ding
    • 1
  • Zi-Jiang Chen
    • 1
    Email author
  1. 1.Centre for Reproductive MedicineProvincial Hospital affiliated to Shandong UniversityJinanChina

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