fertility after age 40


At age 40 and above women have reduced fertility potential as compared to that seen in younger women. They also have substantially lower success rates with fertility treatments including in vitro fertilization (IVF).
For women over 40, the most common cause of infertility is diminished ovarian reserve (DOR), a condition which is characterized by a low number of eggs in a woman’s ovaries and/or impaired development of the existing eggs. A diagnosis of DOR in women over 40 needs to be made rapidly so that effective treatment can quickly follow.
When couples are trying on their own to get pregnant the fertility issue that reduces chances for success is related to the quality of the eggs. With treatments such as IVF, the issue that holds back success potential is both egg quality and egg quantity.

Age Limits for IVF Treatments

  • Most US IVF clinics have an upper age limit for allowing IVF treatment using “own eggs”of somewhere between 42 and 45 years of age.
  • Donor eggs are commonly used until about age 49 – some programs will still do it after age 50

How Does Egg Quality Affect Fertility and IVF?

The quality of the egg is the most critical factor involved in determining the quality of the embryo. With IVF treatment we hope to get multiple embryos so we can choose the best ones from a group for transfer back to the uterus. A big part of the “egg quality” equation involves the chromosomal status of the egg. The rate of chromosomal abnormalities in eggs (and therefore also in embryos) increases significantly with advancing female age. Preimplantation genetic screening (PGS) can be used to test embryos for chromosomally normalcy (euploidy) prior to transferring them to the uterus. Embryos that have normal chromosomal analysis after PGS have a very high potential for implantation and live birth.

How Does Egg Quantity Affect Fertility and IVF Success Rates?

The quantity of eggs remaining in a woman’s ovaries is often referred to as “ovarian reserve”.
The quantity of remaining eggs probably does not have a large impact on natural fertility (trying to get pregnant “naturally”). However, when going through a fertility treatment such as IVF, the quantity of eggs remaining influences response to ovarian stimulating medications.

In Vitro Fertilization Success Rate Statistics by Female Age – and After Age 40

Another important issue is that there is not a substantial decline in success by age of the recipient woman with donor egg IVF.

  • The age of the eggs is very important
  • The age of the uterus carrying the embryos is not important

In Vitro Fertilization Success Statistics
In 2010, the percentage of IVF treatments that resulted in a liv e birth (the success rate) was:

  • 32.2% for women under 35
  • 27.7% for women aged 35-37
  • 20.8% for women aged 38-39
  • 13.6% for women aged 40-42
  • 5% for women aged 43-44
  • 1.9% for women aged over 44

References

https://www.centerforhumanreprod.com//
http://www.advancedfertility.com/
http://www.nhs.uk/

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Dr. Saffarzadeh

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Dr. Saffarzadeh specializes Gynecological Laparoscopic Infertility fellowship at the University of Medical Sciences and two from France.

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