pregnant woman - reproductive choices in older women

Fertility Considerations for Older Women

Infertility clinics have seen an increasing number of women desiring children in their 40s and 50s.  In addition, men aged 60 and even into their 70s desiring to father a child are becoming more common.  In vitro fertilization (IVF) rates using a women’s own eggs in her 40s dramatically decreases even in patients with a relatively normal ovarian reserve for their age (i.e., AMH test).  For instance, the chance of a livebirth is less than 1% in women using their own eggs older than 45 years.  The decline of oocyte yield and egg quality is the greatest contributor to the lower rate of success in women of advanced fertility age.  The rate of aneuploidy (abnormal chromosome number in embryo) exceeds 50% for women over 43 years of age.  Moreover, there is a greater risk of adverse perinatal outcomes (for instance, intrauterine growth restriction, low birth weight and perinatal mortality) in those with advanced maternal age.  One option to help older women increase their chances of conceiving is by using donor eggs (typically form young donors).  In these cases, the success rates improve to over 50% per embryo transfer.  In those seeking a child in their later fertility years it is important to discuss these different options with your fertility specialist to have a realistic understanding of success rates and to learn of more favorable options you may not have previously considered.