In vitro fertilization and oocyte donation in women 45 years of age and older.

OBJECTIVE: To assess the reproductive potential in women > or = 45 years of age. DESIGN: Retrospective analysis. SETTING: In vitro fertilization-embryo transfer unit, standard IVF and oocyte donation programs. PATIENTS: One hundred twenty-seven patients > or = 45 years old who applied for treatment of infertility. INTERVENTION: Thirty-one patients underwent 52 treatment cycles in standard IVF. Ninety-six patients underwent 220 oocyte donation cycles. RESULTS: Of the 52 standard IVF cycles, oocytes were retrieved successfully in only 32. Of these, fertilization and ET were performed in 21 cycles. None of these treatment cycles resulted in a clinical pregnancy. Of the 220 oocyte donation cycles, fertilization and ET were accomplished in 189 cycles. These resulted in 33 (17.5% per transfer) clinical pregnancies. CONCLUSIONS: These results suggest that oocyte donation may extend the reproductive potential in women > or = 45 years old when little hope is offered by standard IVF.

Presumed immune thrombocytopenia and carcinoma: report of three cases and review of the literature.

Three patients presenting in a one-year period with coexisting carcinoma and presumed immune thrombocytopenia are the subject of this report. Review of the literature disclosed a paucity of previous reports of this association. Possible pathogenic mechanisms resulting in this association are discussed. All three patients responded to corticosteroids in usual doses used in treatment of chronic idiopathic thrombocytopenic purpura. The association of carcinoma with immune thrombocytopenia may be more common than has been previously appreciated.