Age and fertility: Is pregnancy possible over 40?

Age and fertility: Is pregnancy possible over 40?

Considering the fast paced life it has become an ordinary practice for a woman to mull over having a baby post 40. But of course this age bracket attracts a lot of difficulties as the by this time your eggs in the ovaries age too and you are further prone to genetic abnormalities.

In females over 40, diminished ovarian reserve is the most common cause of infertility as the number of eggs in a woman’s ovaries decreases and there can also be impaired growth of the existing eggs.

Apart from the fact that chances of pregnancies go down in your 40’s, even the risk linked with pregnancies is augmented for example, miscarriage chances are higher. As per American Society for Reproductive Medicine (ASRM) it has been indicated that risk of miscarriage is 10 percent if a woman is in the age bracket of 20-24, risk goes up to 12 percent between 30 to 34 years, those in the age group of 40 – 44 are at risk of 34 percent, while over 45, the risk of miscarriage is as high as 53 percent.

Existing treatment option for age related fertility problems: In Vitro Fertilization (IVF)

Most fertility experts suggest that females over 38 who are infertile should be advised aggressive fertility treatments and move to IVF at the earliest, that is, before fertility potential is gone.

Intrauterine insemination (IUI) is typically  done for approximately  3 cycles in women under the age 40

As IUI success rate reduces with the age of the female, so older women often favor IVF after undergoing unsuccessful IUIs.

IVF in the 40s

Due to the decline in fertility related to the age factor many couples adhere to advanced infertility treatments such as IVF, to surmount this age related fertility fiasco.

Undeniably Women’s emancipation has changed the outlook on many fronts but what the society has forgotten is that the delay in child bearing impacts fertility decline considerably. We need to alter the impractical belief that advancement in medical science can balance out the effect of aging. Therefore age also lower success rates with fertility treatments like IVF significantly.

Just as with couples who are trying naturally to get pregnant and the fertility concern that lowers probability for success is dependent on quality of the eggs. Similarly, with advanced fertility treatments like IVF, the problem that interferes with the success is attributed to both quality of the egg and quantity.

Age restrictions for IVF treatments in general include

Usually IVF clinics have an upper cut off limit for age for permitting IVF treatment using your own egg which is between  42 and 45 years of age.

Often donor eggs are widely used by the age of 49 or 50 depending on individual clinics.

Impact of egg quality on IVF

The most critical factor underlying embryo quality is the egg quality. The aim of a good IVF treatment is to procure multiple embryos so that the best can be chosen for transferring to uterus.

Also another significant part of egg quality is the chromosomal ranking of the egg. There is increase in the rate of chromosomal abnormalities in eggs (and therefore also in embryos) with the age. Pre-implantation genetic screening is used to determine in embryos for chromosomally normalcy before transferring them to the womb. Those embryos with normal chromosomal analysis post PGS have a very high possibility for implantation and live birth.

Impact of Egg Quantity on IVF Success Rates

  • The quantity of remaining eggs impacts response to ovarian stimulating medications while being subjected to a fertility treatment such as IVF.
  • More eggs remaining indicate more eggs retrieved in the IVF cycle.
  • Also the more eggs in quantity in an IVF cycle, it offers a higher chance for successful pregnancy.

The earlier the better!

Hence, for the infertile couple posed with fertility issues hindering pregnancy can be emotionally stressful and frustrating specially as you age. And certainly seeking medical help at the earliest is a wise decision. And if you are over 39, and trying consistently to get pregnant for six months and had no success it is an alarming situation as the biological clock is ticking, therefore seek immediate medical help.

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