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Predicting suitable timing for artificial reproductive technology treatment in aged infertile women

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Reproductive Medicine and Biology

Abstract

It has been widely accepted that the age of women plays a fundamental role in fecundity, and age-related fertility decline has one of the most significant and detrimental effects on the success rate of infertility treatment. Therefore, treatment cycles of non-in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment for infertile women of advanced aged have been limited due to their lack of efficacy, and they are often optimized, compared to IVF/ICSI treatment. Recent trends in infertility treatment apparently indicate that IVF/ICSI treatment, including egg donation, is frequently offered to aged women for first-line management, despite its heavy burden, but hasty IVF/ICSI treatment should be avoided, considering its socioeconomic problems. It is important to distinguish women who could conceive by non-IVF/ICSI treatment, although the optimization of non-IVF/ICSI treatment protocols remains poorly understood. This review focuses on extracting aged patients who have higher chance of conceiving with non-IVF/ICSI treatment and providing necessary and sufficient infertility treatment. After initial evaluation for fertility, including tubal factor, male factor, the presence of endometriosis and/or adenomyosis, and ovarian reserve, the outcomes of fertility treatment can be predicted to some extent in aged infertile women.

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Abbreviations

AFC:

Antral follicle count

AMH:

Anti-Müllerian hormone

ART:

Assisted reproductive technology

ASRM:

American society for reproductive medicine

BMI:

Body mass index

CC:

Clomiphene citrate

CPR:

Cumulative pregnancy rate

GS:

Gestational sac

hMG:

Human menopausal gonadotropin

ICSI:

Intracytoplasmic sperm injection

IUI:

Intrauterine insemination

IVF:

In vitro fertilization

RCT:

Randomized controlled trial

rFSH:

Recombinant FSH

PR:

Pregnancy rates

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Acknowledgments

This report was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture, The Mochida Memorial Foundation for Medical and Pharmaceutical Research, and The Nakatomi Foundation. This report was also supported by the Japan Society for Reproductive Medicine. The authors would like to thank American Journal Experts (http://www.aje.com) for the English language review.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 1113-8655, Japan

    Nana Akino, Wataru Isono & Osamu Wada-Hiraike

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  1. Nana Akino
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  2. Wataru Isono
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  3. Osamu Wada-Hiraike
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Correspondence to Osamu Wada-Hiraike.

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Akino, N., Isono, W. & Wada-Hiraike, O. Predicting suitable timing for artificial reproductive technology treatment in aged infertile women. Reprod Med Biol 15, 253–259 (2016). https://doi.org/10.1007/s12522-016-0241-0

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