Having a baby in your 40s with ART: the reproductive dilemma of autologous versus donor oocytes.

Hogan, R; Wang, AY; Li, Z; Hammarberg, K; Johnson, L; Mol, BW; Sullivan, E

Having a baby in your 40s with ART: the reproductive dilemma of autologous versus donor oocytes.

Hogan, R

Wang, AY Li, Z Hammarberg, K Johnson, L Mol, BW Sullivan, E

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
Issue Date:: 2020-04-22

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Field	Value	Language
dc.contributor.author	Hogan, R https://orcid.org/0000-0001-6239-5798
dc.contributor.author	Wang, AY
dc.contributor.author	Li, Z
dc.contributor.author	Hammarberg, K
dc.contributor.author	Johnson, L
dc.contributor.author	Mol, BW
dc.contributor.author	Sullivan, E
dc.date.accessioned	2020-05-23T06:05:46Z
dc.date.available	2021-04-27T19:03:10Z
dc.date.issued	2020-04-22
dc.identifier.citation	Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
dc.identifier.issn	0004-8666
dc.identifier.issn	1479-828X
dc.identifier.uri	http://hdl.handle.net/10453/140897
dc.description.abstract	BACKGROUND:Increasing numbers of women ≥40 years old are accessing assisted reproductive technology (ART) due to age-related infertility. There is limited population-based evidence about the impact on the cumulative live birth rate (CLBR) of women aged ≥40 years using their own oocytes, compared to women of a similar age, using donor oocytes. AIMS:To compare the CLBR for women ≥40 years undergoing ART using autologous oocytes and women of similar age using donor oocytes. MATERIALS AND METHODS:This population-based retrospective cohort study used data from all women aged ≥40 years undergoing ART with donated (n = 987) or autologous oocytes (n = 19 170) in Victoria, Australia between 2009 and 2016. A discrete-time survival model was used to evaluate the CLBR following ART with donor or autologous oocytes. The odds ratio, adjusted for woman's age; male age; parity; cause of infertility; and the associated 95% confidence intervals (CI), were calculated. The numbers needed to be exposed (NNEs) were calculated from the adjusted odds ratio (aOR) and the CLBR in the autologous group. RESULTS:The CLBR ranged from 28.6 to 42.5% in the donor group and from 12.5% to 1.4% in the autologous group. The discrete-time survival analysis with 95% CI demonstrated significant aOR on CLBR across all ages (range aOR: 2.56, 95% CI: 1.62-4.01 to aOR: 15.40, 95% CI: 9.10-26.04). CONCLUSIONS:Women aged ≥40 years, using donor oocytes had a significantly higher CLBR than women using autologous oocytes. The findings can be used when counselling women ≥40 years about their ART treatment options and to inform public policy.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Australian and New Zealand Journal of Obstetrics and Gynaecology
dc.relation.isbasedon	10.1111/ajo.13179
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Having a baby in your 40s with ART: the reproductive dilemma of autologous versus donor oocytes.
dc.type	Journal Article
utslib.location.activity	Australia
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Provost
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Provost/Jumbunna
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2020-05-23T06:05:43Z
pubs.publication-status	Published

Abstract:

BACKGROUND:Increasing numbers of women ≥40 years old are accessing assisted reproductive technology (ART) due to age-related infertility. There is limited population-based evidence about the impact on the cumulative live birth rate (CLBR) of women aged ≥40 years using their own oocytes, compared to women of a similar age, using donor oocytes. AIMS:To compare the CLBR for women ≥40 years undergoing ART using autologous oocytes and women of similar age using donor oocytes. MATERIALS AND METHODS:This population-based retrospective cohort study used data from all women aged ≥40 years undergoing ART with donated (n = 987) or autologous oocytes (n = 19 170) in Victoria, Australia between 2009 and 2016. A discrete-time survival model was used to evaluate the CLBR following ART with donor or autologous oocytes. The odds ratio, adjusted for woman's age; male age; parity; cause of infertility; and the associated 95% confidence intervals (CI), were calculated. The numbers needed to be exposed (NNEs) were calculated from the adjusted odds ratio (aOR) and the CLBR in the autologous group. RESULTS:The CLBR ranged from 28.6 to 42.5% in the donor group and from 12.5% to 1.4% in the autologous group. The discrete-time survival analysis with 95% CI demonstrated significant aOR on CLBR across all ages (range aOR: 2.56, 95% CI: 1.62-4.01 to aOR: 15.40, 95% CI: 9.10-26.04). CONCLUSIONS:Women aged ≥40 years, using donor oocytes had a significantly higher CLBR than women using autologous oocytes. The findings can be used when counselling women ≥40 years about their ART treatment options and to inform public policy.

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http://hdl.handle.net/10453/140897