Success rates and cost of a live birth following fresh assisted reproduction treatment in women aged 45 years and older, Australia 2002-2004

BACKGROUND: The aim of this study was to calculate assisted reproductive technology (ART) success rates for fresh autologous and donor cycles in women aged > or = 45 and the resultant cost per live birth. METHODS: We performed a retrospective population-based study of 2339 ART cycles conducted in Australia, 2002-2004 to women aged > or = 45 years. The cost-outcome study was performed on fresh autologous treatment cycles. RESULTS: There were 1101 fresh autologous cycles initiated in women aged > or = 45, with a pregnancy rate of 1.9 per 100 initiated cycles. There were 21 women who achieved a clinical pregnancy with 15 (71%) ending in early pregnancy loss and 6 in live singleton births. The live birth rate following fresh autologous initiated cycles was 0.5% [95% confidence interval (CI): 0.1-1.0%]. Fresh donor recipients had an higher live birth rate of 19.1% (95% CI: 15.1-23.2) (odds ratio 43.2; 95% CI: 18.6-100.3) compared with women having fresh autologous cycles. The average cost of a live birth following fresh autologous cycles was 753,107 euros. CONCLUSIONS: The success rate of fresh autologous treatment for women aged > or = 45 years was < 1%. The very high cost of a live birth reflects a treatment failure rate of > 99%. The ART profession should counsel patients of the reality of the technology before the patients consent to treatment.