In vitro fertilization in the older patient

Seth G. Derman, David B. Seifer

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


In vitro fertilization (IVF) in the older patient presents a significant challenge to the clinician. Older IVF patients have higher cancellation rates, lower oocyte yields, lower pregnancy rates, and higher miscarriage rates, despite significant improvements in IVF success rates in the past decade. Markers of diminished ovarian reserve, including basal follicle-stimulating hormone and estradiol levels, clomiphene citrate challenge test, inhibin B, müllerian-inhibiting substance, ovarian volume, and antral follicle counts, can be useful in counseling patients. Alterations in the stimulation protocol, such as changing the gonadotropin or gonadotropin-releasing hormone (GnRH) agonist dose, use of the agonist flare or microdose flare protocols, or use of a GnRH antagonist have met with varying degrees of success in improving outcomes.

Original languageEnglish (US)
Pages (from-to)375-383
Number of pages9
JournalCurrent women's health reports
Issue number5
StatePublished - Oct 2003
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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