MEDICINE / FERTILITY : No Age Barrier Seen for Egg-Transfer Pregnancies

A sophisticated reproductive technique that has enabled some menopausal women to bear children appears to work as well in women over 40 as in younger women, according to a new report by USC researchers.

The study of 100 patients suggests that the technique, which involves the use of eggs from younger women, can in some instances reverse the normal age-related decline in human fertility. The underlying problem may be the age of the egg, not the age of the other reproductive organs.

“Our data provide reassurance that many individuals, regardless of age, may safely achieve pregnancy long after the ovary ceases to function,” the report said.

“It is a very encouraging study because of the large numbers (of patients) and the good outcomes,” said Dr. Mark V. Sauer of USC, who conducted the research with Dr. Richard J. Paulson and Dr. Rogerio Lobo.

The study is being published today in the Journal of the American Medical Assn. The findings confirm a 1990 report on the techniques by the USC research team.

But while offering encouragement, the report cautions that “currently, more women fail reproductive therapies than succeed” and that there is no consensus on the question of “how old is too old” for the egg transfer technique.

An additional reason for caution is that the successes have been achieved in carefully screened women who, aside from ovarian failure, or menopause, are in good physical and psychological health.

“Beyond 50 years of age, little is known about the ability to achieve pregnancy or the wisdom of establishing it,” the USC physicians said.

The egg donors are usually paid--in the USC program, about $2,000 per egg donation--and identified by the recipients themselves. Only a limited number of women have been willing to become egg donors.

“This treatment may be so successful in fact, that consumer demand may outstrip our ability to provide the necessary oocyte (egg) donors,” Dr. Martin M. Quigley, an infertility specialist in Beachwood, Ohio, wrote in an editorial published in the medical journal with the study.

Quigley also expressed concern about the use of the treatment “not so much to correct a disease or malfunctioning organ system, but rather to reverse part of the normal aging process.”

Menopause develops as hormone production by ovaries decreases. In the United States, the typical age for menopause is between 48 and 51, but reproductive capability generally declines after age 35.

In addition to the eggs from another woman, the study participants also received hormonal supplements and test tube fertilization as a treatment for infertility. They ranged in age from 24 to 55. At USC, the treatment costs about $11,500 per attempt, including the costs of egg donation, Sauer said.

The researchers compared the pregnancy outcomes for women under 40 to the results for women 40 and older. The researchers found that the older women became pregnant 34.5% of the time after the treatment, compared to a rate of 32.6% for the younger women. This difference was not regarded as significant.

By comparison, pregnancy success rates for woman over 40 are usually less than 10% per attempt.

So far, 34 of the women 40 or older have become pregnant. Of these, 29 have had babies, including some having twins and triplets, and five have had miscarriages, Sauer said.