Successful use of gamete intrafallopian transfer does not reverse the decline in fertility in women over 40 years of age.
 To assess the impact of assisted reproductive technologies on the potential fertility of older women, we report our experience with gamete intrafallopian transfer (GIFT) in a large number of women 40 years of age and older.
 One hundred twenty-two GIFT cycles were initiated in 59 women over 18 months.
 Seventy-three tubal transfers were performed, resulting in seven clinical pregnancies, a rate of 9.6% per transfer.
 This contrasts with a 27.3% clinical pregnancy rate per transfer in women under 40.
 Thus, older patients require thorough counseling regarding the decreased likelihood of success despite the use of assisted reproductive technologies.
