Women over the age of 50 who achieve a viable pregnancy via donor-egg in vitro fertilization (D-IVF) have no greater incidence of adverse outcomes than younger women, according to a new study published in the American Journal of Perinatology.
The authors concluded that, “Women ≥ 50 years who achieve pregnancy via D-IVF are at high risk for maternal complications, particularly hypertensive disorders and cesarean section, but at rates similar to those seen in younger recipients.”
Dr. Daniel H. Kort, a postdoctoral fellow from the department of obstetrics and gynecology at Columbia University Medical Center, New York, and colleagues examined the safety profile of pregnancies via IVF with donor eggs through a large, single-center case series and retrospective cohort analysis via a controlled study. The authors compared perinatal outcomes for women 50 years old or older (N=101) who achieved a viable pregnancy via D-IVF with the outcomes of women 42 years of age or younger (N=41) who also achieved viable pregnancy via D-IVF. Their study is the largest single-center study of its kind.
Kort and colleagues did not find a statistically significant difference in the rate of adverse outcomes between the two groups. Compared to their younger cohorts, older women had statistically similar rates of hypertensive disorders of pregnancy (23% versus 14%, odds ratio=1.9), gestational diabetes (4.0% versus 3.0%, odds ratio=1.4), preterm premature rupture of membranes/preterm labor (8.9% versus 14%, odds ratio=0.59), and abnormal placentation (2.1% versus 0%). Rates of cesarean section were higher among the group of older women.
Neonatal outcomes were also similar across the groups of women. Kort et al. found excellent gestational age and birth weight statistics in both the older women and younger women; the researchers noted these outcomes were similar across the groups.
In a statement to the press, Kort added, “Although many social and ethical questions surround the use of assisted reproductive technology by this age group, the current study confirms the high success rate and relative safety of such pregnancies in well-cared-for women.”
“It is imperative that all older women undergo thorough medical screening before attempting pregnancy to ensure the best possible outcome,” added co-author Dr. Mark Sauer, professor of obstetrics and gynecology at Columbia University Medical Center. “But, really, that should apply to younger women, as well.”
B mode and 3D Ultrasound images of a fetal abdomen (35wks) revealing gallbladder calculi
This case study shows a 26 week gestation with a cystic mass close to the sacrum.
CC is a 31 year old primigravida who was referred for ultrasound at a community hospital due to suspected cardiac anomalies noted on a screening sonogram at her doctor's office. Due to concern about a probable cardiac abnormality an amniocentesis was performed at the local hospital.
Single umbilical artery color doppler, transverse scan of urinary bladder shows single umbilical artery (left), transverse section of umbilical cord showing only two vessels: one vein and one artery (right).
Normal 35 week pregnancy
An approx. 12 week fetus, first ultrasound of this pregnancy.
4D image of 29 weeks pregnancy, multiple anomalies: Clinch hand, omphalocoele, single atrium
Is this lesion a fibroid or adenomyosis? Patient is a young (38n yr. old) married female with a history of dysmenorrhea and polymenorrhoea.
The patient was a 38 year old G4 P3, 20w4d. I was doing an anatomic survey today. While I was looking at a long axis view of the fetal heart with color Doppler, the baby developed hiccups, and with each contraction of the fetal thorax (which was quite obvious) I could see an explosion of blue color representing blood going through the foramen ovale from right to left.
This is a confirmed case of scar ectopic pregnancy. Yesterday, I carried out this exam in an emergency room, without much time to perform an adequate sonogram, the patient did not feel good with “cramps” but no signs of bleeding.
Normal aspect of the ossification centers of the fetal sternum at 33 weeks. Size of the ossification centers decreases in a cranio-caudal sense.
Leiomyoma that has undergone fatty degeneration.
Sagittal image from a transvaginal sonogram in a patient with bleeding after a spontaneous abortion. The endometrium (between cursors) was thick and heterogeneous, measuring 8.5 mm in thickness (Fig1). Color doppler image in same patient shows focal flow (Fig. 2 - arrow) within the heterogeneous endometrium.
Images of "Bulky Uterus"
Cystic spaces in the sub-endometrial myometrium of the fundus.
Complete Invasive Mole
A 29-year-old gravida 10, para 3 (1 term gestation, 1 preterm gestation of twins, 1 stillbirth at 5 months, 2 spontaneous abortions, and 4 elective abortions) presented to the clinic at about 5 weeks’ gestation with abdominal pain and vaginal bleeding. She described the pain as sporadic, mostly on the left side, exacerbated by movement, and resolving with rest, and the bleeding as initially intermittent but then heavier “like a period.”
Implantation in the scar of a previous Cesarean is thought to be the rarest of ectopic pregnancies. With the increasing numbers of Cesareans performed, scar implantation may become more frequent as well. We present an illustrative case.
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome affects at least 1 in 4500 female births.1 The syndrome consists of vaginal aplasia with other müllerian duct abnormalities. The characteristic feature of MRKH syndrome is congenital absence or underdevelopment of the upper vagina and uterus; it is rarely associated with unilateral renal agenesis, ectopia, or horseshoe kidney.
Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years.
