Artigos Originais Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):300-304
DOI 10.1590/S0100-72032009000600006
PURPOSE: to study vulvovaginal candidiasis from the vaginal fluid of women with and without clinical suspicion, identifying the frequency of Candida spp., and associating it with intrinsic and extrinsic risk factors. METHODS: a total of 286 samples from patients attended in private practices and public health units from August 2005 to August 2007 were collected, being 121 women under clinical suspicion and 165, without. The samples were collected with sterile swabs, taken to the laboratory in 0.85% physiological solution, and then seeded in CHROMagar Candida and in 4% agar Sabourad with chloramphenicol. Classical identification procedures were carried out: macro and micromorphology, zymogram and auxanogram. Data obtained were analyzed by frequency tests and contingency tables (χ2). RESULTS: a total of 47.9% of the women under clinical suspicion got confirmation of candidiasis by the laboratorial tests. Among the patients without clinical suspicion (Control Group), 78.2% were vulvovaginal candidiasis negative according to the laboratorial tests. Candida albicans was the prevalent strain in 74.5% of the cases. There were significant differences among the positive cases, according to the patients from the two cities evaluated (p<0.05). Clothing was one differential aspect found among the two populations studied. CONCLUSIONS: the presence of predisposing factors does not necessarily define vulvovaginal candidiasis. Geographical localization has shown to be a relevant factor in the distribution of events. The type of clothing may be one of the reasons for it. Culture of samples from the vaginal contents, followed by microorganisms' identification, can be important.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):300-304
DOI 10.1590/S0100-72032009000600006
PURPOSE: to study vulvovaginal candidiasis from the vaginal fluid of women with and without clinical suspicion, identifying the frequency of Candida spp., and associating it with intrinsic and extrinsic risk factors. METHODS: a total of 286 samples from patients attended in private practices and public health units from August 2005 to August 2007 were collected, being 121 women under clinical suspicion and 165, without. The samples were collected with sterile swabs, taken to the laboratory in 0.85% physiological solution, and then seeded in CHROMagar Candida and in 4% agar Sabourad with chloramphenicol. Classical identification procedures were carried out: macro and micromorphology, zymogram and auxanogram. Data obtained were analyzed by frequency tests and contingency tables (χ2). RESULTS: a total of 47.9% of the women under clinical suspicion got confirmation of candidiasis by the laboratorial tests. Among the patients without clinical suspicion (Control Group), 78.2% were vulvovaginal candidiasis negative according to the laboratorial tests. Candida albicans was the prevalent strain in 74.5% of the cases. There were significant differences among the positive cases, according to the patients from the two cities evaluated (p<0.05). Clothing was one differential aspect found among the two populations studied. CONCLUSIONS: the presence of predisposing factors does not necessarily define vulvovaginal candidiasis. Geographical localization has shown to be a relevant factor in the distribution of events. The type of clothing may be one of the reasons for it. Culture of samples from the vaginal contents, followed by microorganisms' identification, can be important.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):285-292
DOI 10.1590/S0100-72032009000600004
PURPOSE: to investigate the main factors associated with fetal death in the city of Recife, Pernambuco, Brazil. METHODS: an observational, case-control study, including cases attended from June 1st 2004 to 31st March 2005. A number of 116 stillbirth cases and 472 live birth controls, with deliveries assisted at the service, were included. The cases were identified in the record book from the delivery room. The puerperium women were identified by the name and register number at a puerperium infirmary. The controls were selected, using the puerperium infirmary neighborhood criterion, identifying the beds with numbers immediately lower (two patients) and higher (two patients) than the patient's, as far as they had delivered live babies. In case they did not agree to participate in the research, the next beds with numbers consecutively lower or higher were approached. The χ2 association and Fisher's exact tests were used when necessary to test the association between the independent (predictive) and dependent (stillborn) variables, considering 5% as the significance level. To determine the association strength, the estimate of relative risk for case-control cases, Odds Ratio (OR) was used, with 95% as the confidence interval (CI). Logistic regression analysis according to the hierarchy model was done to control confounding factors. RESULTS: the fetal mortality rate corresponded to 24.4 by 1,000 births. After the multivariate analysis, the variables which kept significantly associated with fetal death were: malformation (OR=7.5; CI=3.2-17.4), number of pre-natal appointments lower than six (OR=4.4; CI=2.5-7.5), hemorrhagic syndromes (OR=2.9; CI=1.4-5.7), attendance in another hospital unit along the 24 hours which preceded the patient's admission in the institution (OR=2.9; CI=1.8-4.6), mothers' age over or equal to 35 years old (OR=2.2; CI=1.0-4.9) and schooling lower than eight years (OR=1.6; CI=1.02-2.6). CONCLUSIONS: it was found a high fetal mortality coefficient, the main factors associated with death were: malformation, number of pre-natal appointments lower than six, hemorrhagic syndromes, history of attendance previous to the hospital admission, mothers' age over or equal to 35 and schooling lower than eight years.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):285-292
DOI 10.1590/S0100-72032009000600004
PURPOSE: to investigate the main factors associated with fetal death in the city of Recife, Pernambuco, Brazil. METHODS: an observational, case-control study, including cases attended from June 1st 2004 to 31st March 2005. A number of 116 stillbirth cases and 472 live birth controls, with deliveries assisted at the service, were included. The cases were identified in the record book from the delivery room. The puerperium women were identified by the name and register number at a puerperium infirmary. The controls were selected, using the puerperium infirmary neighborhood criterion, identifying the beds with numbers immediately lower (two patients) and higher (two patients) than the patient's, as far as they had delivered live babies. In case they did not agree to participate in the research, the next beds with numbers consecutively lower or higher were approached. The χ2 association and Fisher's exact tests were used when necessary to test the association between the independent (predictive) and dependent (stillborn) variables, considering 5% as the significance level. To determine the association strength, the estimate of relative risk for case-control cases, Odds Ratio (OR) was used, with 95% as the confidence interval (CI). Logistic regression analysis according to the hierarchy model was done to control confounding factors. RESULTS: the fetal mortality rate corresponded to 24.4 by 1,000 births. After the multivariate analysis, the variables which kept significantly associated with fetal death were: malformation (OR=7.5; CI=3.2-17.4), number of pre-natal appointments lower than six (OR=4.4; CI=2.5-7.5), hemorrhagic syndromes (OR=2.9; CI=1.4-5.7), attendance in another hospital unit along the 24 hours which preceded the patient's admission in the institution (OR=2.9; CI=1.8-4.6), mothers' age over or equal to 35 years old (OR=2.2; CI=1.0-4.9) and schooling lower than eight years (OR=1.6; CI=1.02-2.6). CONCLUSIONS: it was found a high fetal mortality coefficient, the main factors associated with death were: malformation, number of pre-natal appointments lower than six, hemorrhagic syndromes, history of attendance previous to the hospital admission, mothers' age over or equal to 35 and schooling lower than eight years.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):279-284
DOI 10.1590/S0100-72032009000600003
PURPOSE: to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. METHODS: cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. RESULTS: in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. CONCLUSIONS: neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic condition.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):279-284
DOI 10.1590/S0100-72032009000600003
PURPOSE: to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. METHODS: cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. RESULTS: in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. CONCLUSIONS: neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic condition.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):249-253
DOI 10.1590/S0100-72032009000500008
PURPOSE: to compare the expression of tumor necrosis factor-alpha (TNF-α) in ovular membranes with premature rupture (MPR) and with opportune rupture; to verify the association between the expression of the TNF-α in ovular membranes and the degree of chorioamnionitis, correlating the expression of the TNF-α and the membranes' time of rupture. METHODS: ovular membranes from 31 parturients with MPR, with gestational ages over 34 weeks, and from parturients with opportune membranes' rupture, with gestational ages equal or over 37 weeks. Chorioamnionitis detection has been done by histopathological analysis. The evaluation of the TNF-α expression has been done by immune-histochemical technique, using the labile streptavidin-biotin-peroxidase (LSAB) method. RESULTS: the average rupture time was 16.6 hours. The ratio of the TNF-α expression in the Control and Study Groups did not show a significant difference (χ2=6.6; p=0.08). In the Study Group, there was no correlation between the degree of chorioamnionitis and the intensity of TNF-α expression (Spearman's coefficient (Rs)=0.4; p=0.02). CONCLUSIONS: there was no significant difference between the TNF-α expression in ovular membranes with premature or opportune rupture; in the Study Group, there was significant association between TNF-α expression and the degree of chorioamnionitis, and there was no association between rupture time and the intensity of TNF-α expression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):249-253
DOI 10.1590/S0100-72032009000500008
PURPOSE: to compare the expression of tumor necrosis factor-alpha (TNF-α) in ovular membranes with premature rupture (MPR) and with opportune rupture; to verify the association between the expression of the TNF-α in ovular membranes and the degree of chorioamnionitis, correlating the expression of the TNF-α and the membranes' time of rupture. METHODS: ovular membranes from 31 parturients with MPR, with gestational ages over 34 weeks, and from parturients with opportune membranes' rupture, with gestational ages equal or over 37 weeks. Chorioamnionitis detection has been done by histopathological analysis. The evaluation of the TNF-α expression has been done by immune-histochemical technique, using the labile streptavidin-biotin-peroxidase (LSAB) method. RESULTS: the average rupture time was 16.6 hours. The ratio of the TNF-α expression in the Control and Study Groups did not show a significant difference (χ2=6.6; p=0.08). In the Study Group, there was no correlation between the degree of chorioamnionitis and the intensity of TNF-α expression (Spearman's coefficient (Rs)=0.4; p=0.02). CONCLUSIONS: there was no significant difference between the TNF-α expression in ovular membranes with premature or opportune rupture; in the Study Group, there was significant association between TNF-α expression and the degree of chorioamnionitis, and there was no association between rupture time and the intensity of TNF-α expression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):241-248
DOI 10.1590/S0100-72032009000500007
OBJECTIVE: to determine the frequency of macrosomia in babies born alive at a reference obstetric service, and its association with maternal risk factors. METHODS: a transversal descriptive study, including 551 women at puerperium, hospitalized at Instituto de Saúde Elpídio de Almeida, in Campina Grande (PB), Brazil, from August to October, 2007. Women, whose deliveries had been assisted at the institution, with babies born alive from one single gestation and approached in the first postpartum day, were included in the study. The nutritional and sociodemographic maternal characteristics were analyzed, and the ratio of macrosomia (birth weight >4.000 g) and its association with maternal variables were determined. Macrosomia was classified as symmetric or asymmetric according to Rohrer's index. Statistical analysis has been done through Epi-Info 3.5 software; the prevalence ratio (PR) and the confidence interval at 95% (CI 95%) were calculated. The research protocol was approved by the local Ethics Committee and all the participants signed the informed consent. RESULTS: the mean maternal age was 24.7 years old, and the mean gestational age was 38.6 weeks. Excessive gestational weight gain was observed in 21.3% of the pregnant women, and 2.1% of the participants had a diagnosis of diabetes mellitus (gestational or clinic). A ratio of 5.4% of macrosomic newborns was found, 60 were asymmetric. There was no significant association between macrosomia, mother's age and parity. There was an association between macrosomia and overweight/obesity in the pre-gestational period (PR=2.9; CI 95%=1.0-7.8) and at the last medical appointment (PR=4.9; CI 95%=1.9-12.5), excessive weight gain (PR = 6.9; CI 95%:2.8-16.9), clinical or gestational diabetes (PR = 8.9; CI 95%:4.1-19.4) and hypertension (PR=2.9; CI 95%=1.1-7.9). The factors that persisted significantly associated with macrosomia in the multivariate analysis were the excessive weight gain during the gestation (RR=6.9; CI 95%=2.9-16.9) and the presence of diabetes mellitus (RR=8.9, CI 95%=4.1-19.4). CONCLUSIONS: considering that excessive gestational weight gain and diabetes mellitus were the factors more strongly associated with macrosomia, it is important that precocious detection measurements and adequate follow-up of such conditions be taken, aiming at preventing unfavorable perinatal outcomes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):241-248
DOI 10.1590/S0100-72032009000500007
OBJECTIVE: to determine the frequency of macrosomia in babies born alive at a reference obstetric service, and its association with maternal risk factors. METHODS: a transversal descriptive study, including 551 women at puerperium, hospitalized at Instituto de Saúde Elpídio de Almeida, in Campina Grande (PB), Brazil, from August to October, 2007. Women, whose deliveries had been assisted at the institution, with babies born alive from one single gestation and approached in the first postpartum day, were included in the study. The nutritional and sociodemographic maternal characteristics were analyzed, and the ratio of macrosomia (birth weight >4.000 g) and its association with maternal variables were determined. Macrosomia was classified as symmetric or asymmetric according to Rohrer's index. Statistical analysis has been done through Epi-Info 3.5 software; the prevalence ratio (PR) and the confidence interval at 95% (CI 95%) were calculated. The research protocol was approved by the local Ethics Committee and all the participants signed the informed consent. RESULTS: the mean maternal age was 24.7 years old, and the mean gestational age was 38.6 weeks. Excessive gestational weight gain was observed in 21.3% of the pregnant women, and 2.1% of the participants had a diagnosis of diabetes mellitus (gestational or clinic). A ratio of 5.4% of macrosomic newborns was found, 60 were asymmetric. There was no significant association between macrosomia, mother's age and parity. There was an association between macrosomia and overweight/obesity in the pre-gestational period (PR=2.9; CI 95%=1.0-7.8) and at the last medical appointment (PR=4.9; CI 95%=1.9-12.5), excessive weight gain (PR = 6.9; CI 95%:2.8-16.9), clinical or gestational diabetes (PR = 8.9; CI 95%:4.1-19.4) and hypertension (PR=2.9; CI 95%=1.1-7.9). The factors that persisted significantly associated with macrosomia in the multivariate analysis were the excessive weight gain during the gestation (RR=6.9; CI 95%=2.9-16.9) and the presence of diabetes mellitus (RR=8.9, CI 95%=4.1-19.4). CONCLUSIONS: considering that excessive gestational weight gain and diabetes mellitus were the factors more strongly associated with macrosomia, it is important that precocious detection measurements and adequate follow-up of such conditions be taken, aiming at preventing unfavorable perinatal outcomes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):235-240
DOI 10.1590/S0100-72032009000500006
PURPOSE: to study infection prevalence by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), among adolescent and young women in a family planning outpatient clinic. METHODS: a total of 230 women up to 24 years old and history of up to four sexual partners have been followed-up for 48 months, with urine collection to search CT and NG, by the polymerase chain reaction method at the 1st, 12nd, 24th, 36th and 48th months. The variables studied were age group, schooling, marital status, number of gestations, abortions and children alive, age at the onset of sexual life, previous and present use of condom, previous use of intrauterine device, number of sexual partners in the previous six months and follow-up time. Bivariate analysis of variables according to positive tests for CT and NG, and multiple analyses by logistic regression were done. RESULTS: the ratio of infections by CT was 13.5% and by NG, 3%. Two women presented both tests as positive. The previous intrauterine device use was associated with positive tests for NG. CONCLUSIONS: the prevalence of infections by CT and NG was higher among the age group studied and the screening of young women must be taken into consideration in our services, to control the dissemination of sexually transmitted diseases and prevention of sequels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):235-240
DOI 10.1590/S0100-72032009000500006
PURPOSE: to study infection prevalence by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), among adolescent and young women in a family planning outpatient clinic. METHODS: a total of 230 women up to 24 years old and history of up to four sexual partners have been followed-up for 48 months, with urine collection to search CT and NG, by the polymerase chain reaction method at the 1st, 12nd, 24th, 36th and 48th months. The variables studied were age group, schooling, marital status, number of gestations, abortions and children alive, age at the onset of sexual life, previous and present use of condom, previous use of intrauterine device, number of sexual partners in the previous six months and follow-up time. Bivariate analysis of variables according to positive tests for CT and NG, and multiple analyses by logistic regression were done. RESULTS: the ratio of infections by CT was 13.5% and by NG, 3%. Two women presented both tests as positive. The previous intrauterine device use was associated with positive tests for NG. CONCLUSIONS: the prevalence of infections by CT and NG was higher among the age group studied and the screening of young women must be taken into consideration in our services, to control the dissemination of sexually transmitted diseases and prevention of sequels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):230-234
DOI 10.1590/S0100-72032009000500005
PURPOSE: to evaluate the patient's age as an outcome predictor in an in vitro fertilization (IVF) program. METHODS: transversal study, which has included 302 women with ages varying from 24 to 46 years old, submitted to IVF, from May 2005 to July 2007. The patients were divided in three groups, according to their age: G<35 (n=161), G 36-39 (n=89) e G>40 (n=52). The number of collected oocytes, the fertilization rates, the number of transferred embryos, the embryonary quality and the pregnancy rate were evaluated. Statistical analysis was realized through Kruskal-Wallis variance analysis and χ2 test. RESULTS: in the G<35 group, an average of 8.8 oocytes by patient was obtained; in the G 36-49 group, 7.4; and in the G>40 group, 1.6. The number of oocytes obtained in G>40 group was significantly lower than in the other two groups (p<0.001).The fertilization rate was similar in the three groups, 61.4, 65.8 e 64.6% (p=0.2288), respectively. The percentage of good quality embryos was not statistically different among the three groups either, with rates of 57.4, 63.2 and 56.0% (p=0.2254), respectively. The average number of transferred embryos in each group was 3.1 (G<35), 2.8 (G 36-39) and 1.5 (G>40), respectively, with statistically significant decrease in the G>40 group (p<0.001). Concerning pregnancy rates, the G>40 group has presented a rate of 9.6%, a result which is significantly lower (p=0.0330) than the one presented by the G<35 and G 36-39 groups (26.1 e 27.0%, respectively), with no significant difference between themselves. CONCLUSIONS: though the embryonary quality is not different among women from different age groups, the number of collected oocytes, the number of transferred embryos and the pregnancy rate indicate that the women's age is an important predictive factor of success for the techniques of assisted reproduction and should be taken into consideration when this kind of treatment is proposed to women over 40.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):230-234
DOI 10.1590/S0100-72032009000500005
PURPOSE: to evaluate the patient's age as an outcome predictor in an in vitro fertilization (IVF) program. METHODS: transversal study, which has included 302 women with ages varying from 24 to 46 years old, submitted to IVF, from May 2005 to July 2007. The patients were divided in three groups, according to their age: G<35 (n=161), G 36-39 (n=89) e G>40 (n=52). The number of collected oocytes, the fertilization rates, the number of transferred embryos, the embryonary quality and the pregnancy rate were evaluated. Statistical analysis was realized through Kruskal-Wallis variance analysis and χ2 test. RESULTS: in the G<35 group, an average of 8.8 oocytes by patient was obtained; in the G 36-49 group, 7.4; and in the G>40 group, 1.6. The number of oocytes obtained in G>40 group was significantly lower than in the other two groups (p<0.001).The fertilization rate was similar in the three groups, 61.4, 65.8 e 64.6% (p=0.2288), respectively. The percentage of good quality embryos was not statistically different among the three groups either, with rates of 57.4, 63.2 and 56.0% (p=0.2254), respectively. The average number of transferred embryos in each group was 3.1 (G<35), 2.8 (G 36-39) and 1.5 (G>40), respectively, with statistically significant decrease in the G>40 group (p<0.001). Concerning pregnancy rates, the G>40 group has presented a rate of 9.6%, a result which is significantly lower (p=0.0330) than the one presented by the G<35 and G 36-39 groups (26.1 e 27.0%, respectively), with no significant difference between themselves. CONCLUSIONS: though the embryonary quality is not different among women from different age groups, the number of collected oocytes, the number of transferred embryos and the pregnancy rate indicate that the women's age is an important predictive factor of success for the techniques of assisted reproduction and should be taken into consideration when this kind of treatment is proposed to women over 40.