Based on age when should egg donation be considered as the best first treatment?

This is one of a series of news items from abstracts of studies presented at the Annual Meeting of the American Society for Reproductive Medicine as complied by Dr. David Meldrum, Scientific Director of Reproductive Partners. We appreciate the enormous amount of work it takes to compile and comment on these abstracts.

When a woman over 4o is considering getting pregnant, there is no one factor that gives us a clue as to whether she should try IVF with her own eggs or go directly to egg donation. There are many factors we take into consideration in making that decision: i.e. her FSH and AMH levels, reproductive history, antral follicle count.

In a study presented at ASRM 2012, one center reported their birth rate for IVF cycles with undetectable AMH. In women under age 40 the birth rate was 11% per cycle and 21% per embryo transfer (ET). But in women over age 40 the rates were 2% per cycle and 4% per ET.

A logical conclusion would be that in women over age 40, an undetectable AMH is a very poor prognostic sign and egg donation should be considered. The is a good step in being able to give a couple a much better idea of prognosis, possibly helping them avoid a failed cycle with her own eggs using high doses of fertility drugs, thus saving a lot of money. And with the availability of frozen donor eggs through Donor Egg Bank USA making an egg donation cycle easier, quicker and less expensive, there could be considerable savings.

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