Effect of Egg Donor Age on Egg Donation Success Rates

28.09.2016

In the last two decades there has been a great increase in childbearing among women of mature age in the industrialized world. This is due in part to planned delayed childbearing, but a major contributor is the use of assisted reproductive technology (ART) in women of relatively advanced maternal age. It is well known that maternal age adversely affects fecundity; reproductive capacity in women declines dramatically after they reach 40 because of an abrupt loss of functional oocytes, increasing risk of chromosomes defects, spontaneous abortion, etc. However, the huge advances in reproductive medicine have compensated, to some extent, for this natural decrease in fecundity, and older women can become pregnant through oocyte donation.

Until the last few years little attention has been paid to the possible effects of paternal age in the reduction of fecundity. Advanced men age has been associated with a significant reduction in pregnancy rates, increased time-to-pregnancy and increased sub-fecundity. Some recent papers relate men age with risk of increased DNA damage, spontaneous abortion, stillbirth, fetal death and birth defects.

The question of age-related changes in semen quality remains unsolved. The weight of evidence from clinical and healthy men studies suggests that age is associated with diminished semen volume, sperm motility and/or morphology, but sperm concentration is affected little by age. However, other authors noted no change in sperm quality.

The oocyte donation provides a powerful tool to analyze the influence of men aging on reproductive potential because in these patients oocytes are obtained from a homogeneous and young population of oocyte donors, reducing the variability associated to the oocyte quality from patients.

The purpose of this paper was to evaluate the effect of man and woman age on the reproductive outcome of our oocyte donation program, and study if there is an interaction between man and recipient age. Oocyte donation has become a common treatment modality for a large spectrum of infertility conditions.

At this moment the current legislation of Ukraine has no restrictions. Today the main document regulating the procedure of egg donation in Ukraine is the Order of the Ministry of Healthcare of Ukraine № 787 from 28.07.2016. According to this document, in addition to the health requirements to the donor, she must have her own healthy children; Donor age is limited to 35 years. Within this age aging changes usually do not make any significant impact on the quality of oocytes.

Research Materials and Methods:

This research study is a retrospective review of implantation rates according to data recorded in our egg donor database.It comprises of egg donation cycles from 374 couples that used a donor between 18-35 years old and had a fresh embryo transfer done in our clinic between January 2013 and September 2015.

The cases were split into 2 groups for analysis:

  • the younger egg donor group was 18 to 31 years old;
  • the older donor group was 31 to 35 years old.

Outcomes were compared using clinical pregnancy rates (pregnancies with fetal heart activity seen on ultrasound).

Clinical pregnancy rates:

  • Clinical pregnancy rates were similar in the younger vs. the older donor groups.
  • The clinical pregnancy rates were slightly higher with the older donors at 80,5% than with the younger donors - 78%.
  • However, this difference was not statistically significant.

Egg donation programs have been practiced by our clinic for 15 years with a great passion and care in order to assist people with fertility problems from all over the world who can not become parents otherwise. We offer both fresh egg donation cycles and cycles with vitrified donor oocytes, which are immediately available at Intersono Egg donor bank of vitrified oocytes – the first bank of vitrified oocytes in Ukraine, which enlists more than 450 immediately available egg donors. The success rates of Fresh ED programs are 64%. Egg donation with vitrified oocytes attains 59% CPR.Conclusions: Our study shows no statistical difference in implantation rates or clinical pregnancy rates in egg donation cycles according to how old the donor is (through age 35). Clearly, egg donors would be "too old" at some point to allow for a high pregnancy success rate.

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