Yannick Hurni: Challenging a Long-Standing IVF Dogma
Yannick Hurni, Clinical and Research Fellow in Gynecologic Surgery at Dexeus University Hospital, shared a post on LinkedIn about a paper by Patricia Sebastian-Leon et al. published in Fertility and Sterility:
“Challenging a long-standing IVF dogma
In reproductive medicine, it is often stated that with a perfect embryo, outcomes are equal for all patients.
A new multicenter study on 33,141 single donor blastocyst transfers suggests otherwise.
Even when controlling for embryo quality, donor oocytes, BMI, and HRT protocol, maternal age still negatively affected IVF outcomes:
- Live birth rate declined after 40 years
- Implantation failure increased by 4.2 percent per year after 40
- Pregnancy loss increased by 3.2 percent per year after 43
The study clearly points toward the uterus as an independent limiting factor. However, the analysis could not fully adjust for key uterine variables such as adenomyosis, congenital malformations, endometrial thickness, uterine artery pulsatility, inflammation, or fibrosis.
This work provides strong evidence that:
- The ovarian factor is crucial but not the only one
- Uterine aging exists and impacts implantation and miscarriage
- The endometrium should be considered a therapeutic target in assisted reproductive technology
As someone deeply focused on the uterine and endometrial role in fertility, this study is particularly compelling.”
Title: Advanced maternal age was associated with an annual decline in reproductive success despite use of donor oocytes: a retrospective study
Authors: Patricia Sebastian-Leon, Francisco Jose Sanz, Pietro Molinaro, Antonio Pellicer, Patricia Diaz-Gimeno
Read the full article.

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