ABSTRACT
The most common cause of reduction in human embryo implantation afterin vitro fertilization and embryo transfer [IVF-ET] is the female age. The increase in the age of women results in reduction in the performance of the reproductive function. The aim of the present work was to determine the effect of age of women on intracytoplasmic sperm injection, in vitro embryo cleavage, embryo transfer rate, embryo implantation and pregnancy rates following intracytoplamic sperm injection and embryo transfer [ICSI-ET]. The male patients had asthenospermia with mean sperm motility of 17.15% and the mean sperm motility index was 31.21. The female patients were divided into three groups, group one, 145 women with age <31 years, group two, 129 women with age group from 31-40 years and group three, 49 women with age >40 years. The ovulation induction was induced by human menopausal gonadotropin [hMG] and human chorionic gonadotropin [hCG]. The baseline ofFSHand LH levels on cycle day 3 were significantly increased [P<0.05] in group 3 versus group 1 and 2. The estradiol concentration and the number of dominant follicles and thickness of endometrium were significantly decreased in group 3 compared to group 1 and 2 [P<0.01]. The number of the hMG ampoules was significantly [P< 0.01] higher in group 3 compared to group 1 and 2. The number of the matured oocytes per patient was significantly lower in group 3 compared to group I and 2 [P<0.05]. The ICSI rate was significantly higher in group I compared to group 2 and 3 [86.01% versus 79.07% and 75.68%, P<0.005]. Similar observations were reported in regard to embryo developmental rate and the number of embryo transferred per patient [P<0.05]. The differences between group 2 and 3 in regard to the number of embryo transferred per patient were also statistically significant. The percentage of transferable embryo quality was significantly higher in group I compared to group 2 and 3 P<0.05] and between group 2 and 3 [P<0.025]. The pregnancy rate per patient was significantly reduced in group 3 compared to group I [P<0.05]. The percentage of fetal sac development per implanted embryo was significantly reduced in group 3 compared to group 1 and 2 [25% versus 66.67%, 64.52%]. The percentage of fetal sac development per patient was significantly reduced in group three [>40 years] compared to group one [< 31 years] and group two [31-40 years]. It was concluded from the results of the present study that the advancing age of woman [more than 40 years] adversely affects ICSI, embryo transfer, embryo cleavage rates in addition to pregnancy rate. It also reduces embryo implantation and the development of viable gestation sac in the pregnant women. These effects may involve alterations in the function of the endometrium as well as the quality of the oocytes in aged women