ITALY — A study presented by Dr. Beatrice Crestani and colleagues from IVI Roma indicated that women aged 49 and older experience lower live birth rates and higher miscarriage rates in donor-oocyte in vitro fertilization (IVF) treatments. The research, conducted by the IVIRMA Global Research Alliance, identified age 49 as a threshold for declining reproductive outcomes.

Researchers analyzed 2,760 single blastocyst transfers from 1,774 women undergoing donor-oocyte treatment between March 2021 and December 2024. Clinical pregnancy rates decreased from 54.0% in women aged 35–40 to 42.6% in women aged 49 or older. Live birth rates also declined, from 46.2% in the 35–40 age group to 31.7% for women aged 49 or older. The study found that miscarriage rates increased from 24.2% among women aged 35–40 to 37.6% in the 49 or older age bracket, meaning women 49 and over had more than double the odds of miscarriage compared to the younger group.

Cumulative live birth rates for women transferring all available embryos saw a reduction from 80.0% in the 35–40 age group to 62.5% in women aged 49 or older. The study also noted a decline in the proportion of women with a trilaminar endometrial pattern, from 94.7% for those aged 35–40 to 81.0% for women 49 or older. Despite these findings, the thickness of the uterine lining remained consistent across all studied age groups.

Dr. Crestani, the lead researcher, stated, "Our findings suggest the picture is more complex." She said, "These findings should not discourage women from pursuing donor-oocyte treatment, because success rates remain meaningful even at advanced ages." She added, "However, patients should be counselled that donor eggs cannot completely eliminate the effects of reproductive aging, particularly beyond 49 years."

The study's abstract appeared in the journal Human Reproduction, and its findings were presented at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE). Prof. Borut Kovacic, Chair-elect of ESHRE, commented on the research, saying, "It provides important information for patients and offers a valuable foundation for future research aimed at identifying novel biomarkers of uterine ageing."