Fertility and IVF Treatment for Over 40’s
Fertility tests, IVF treatment and success rates in women over 40
More women now delay starting or completing family for a variety of reasons. The fertility over 40’s is affected in a unique way. As women get older the number and quality of egg cells that are produced by the ovaries declines. About 10% of women may have low ovarian reserve or are affected by early ovarian ageing. Infertility and difficulty in conceiving can cause great emotional distress to couples. Women should ideally be free to choose when to start a family based on personal and professional circumstances, but very little can currently be done to reverse low ovarian reserves or early ovarian aging.
There is decline in natural fertility ever since puberty. The decline in ovarian reserves becomes steeper over the age of 38. Reduced ovarian reserve is caused by natural aging of the ovaries. This results in fewer good quality of eggs. The embryos created using such eggs are more likely to be chromosomally and genetically abnormal. They are also less likely to implant either naturally or after fertility treatments such as IVF. This also results in higher risk of pregnancy miscarriage. With advancements in science and technology, it is now possible to do genetic testing of embryos for chromosomal abnormalities before transfer to optimise treatment outcomes.
Getting pregnant over 40
As women get older, both mothers and babies face an increased risk of pregnancy-related complications and health problems. These may occur in both natural and IVF pregnancies. These are due to changes in the reproductive system and the higher chances of developing of general health problems that come with age.
When you are trying to get pregnant over 40, there is a higher chance that you may face greater difficulty in conceiving naturally. Infertility does cause personal and emotional difficulties for the couples. Besides infertility, there is higher risk of complications both for you and the baby. These may occur in both following natural and IVF pregnancy. Some of the common pregnancy complications that you may face include risk of pregnancy miscarriage, high blood pressure or preclampsia and birth defects such as Down’s syndrome. This is not an exhaustive list of pregnancy complications you may experience.
Despite this, many women who become pregnant in their late 30s and early 40s have perfectly healthy pregnancies and babies. If you are thinking of getting pregnant over 35 or 40, you should be fully informed. You can speak to your gynaecologist or fertility specialist to have better understanding of pregnancy risks, how you can receive optimal care and appropriate medical attention required to meet any needs that arise from becoming a mother.
Fertility tests and IVF treatments over 40
Should I have ovarian reserve testing or ORT? All women who have not conceived after having tried for a reasonable period of time should have fertility tests. Your fertility specialist will suggest the best fertility tests that are appropriate to your unique circumstances. Most women, especially over 40, while thinking of fertility treatment should have ovarian reserve testing amongst other recommended tests.
What is Ovarian Reserve Testing or ORT?
The ‘Ovarian reserve test’ is a common female fertility test that gives information about how well your ovaries are functioning. This is a measure of the egg heath and ovarian aging. It is generally known that female fertility declines with age, but does so more rapidly over 40 years of age. The ovarian reserve test uses a combination of blood tests and ultrasound scan to know more about the egg health before you decide to proceed with any fertility treatment including IVF.
Some of the tests that are done as part of ovarian reserve test or ORT are Anti-Mullerian hormone or AMH, Follicle Stimulating Hormone or FSH, Inhibin B, CCCT and Antral Follicle Count or AFC. None of these tests in isolation gives a reliable measure of ovarian reserve or egg health. Hence, we recommend the most comprehensive female fertility tests, so that you can decide about you best fertility treatment option.
What is the best IVF treatment option for women over 40?
Based on the outcome of the fertility tests, your fertility specialist will recommend your best fertility or IVF treatment option. This may be either choosing fertility treatment either with your own eggs or considering IVF treatment using donated eggs. If you are having treatment with your own eggs, your fertility specialist may also suggest the best IVF treatment option – stimulated or Mild IVF or Natural IVF. IVF treatment with donated eggs is more successful for women over 40 when compared to having treatment with your own eggs. Depending on the outcome of your fertility tests and other factors that may affect your IVF success, your fertility specialist will discuss a number of ways, and latest scientific techniques and interventions that will maximise your chances of getting pregnant.
Is IVF over 40 successful with own eggs?
The IVF success rates depend on your age and the outcome of fertility tests including ovarian reserve testing. If you have low ovarian reserves, then you may have fewer good quality eggs. With the help of advancements in science and use of latest interventions, the IVF treatment success rates in women over 40 have improved over time. However, they are still lower when compared to women less than 35 years of age and with good ovarian reserve.
There are many ways in which our fertility specialists may try to maximise the IVF success. Your fertility specialist will discuss various fertility tests and treatments that are appropriate to your situation. They will work in partnership with you to offer the best IVF treatment that aligns with your wishes and beliefs.
One of the ways to improve IVF success over 40 and especially if you have good ovarian reserve, is to consider preimplanatation genetic testing or PGT (also known as preimplantation genetic screening or PGS). With preimplantation genetic testing for aneuploidy or PGT- A (also known as preimplantation genetic screening / PGS or comprehensive chromosomal screening / CCS), it is now possible to test the embryos with a higher accuracy for chromosomal abnormalities. By replacing chromosomally normal embryos during IVF treatment, you may be able to achieve the best IVF treatment success or pregnancy rates. There are pros and cons of genetic testing of embryos or PGS, which should be duly considered before you start fertility treatment.
What are the best fertility treatment options for women with low ovarian reserve?
The fertility treatment options for women with low ovarian reserves are limited. How does low ovarian reserves reduce chances of getting pregnant naturally or after fertility or IVF treatment? Generally speaking, low (reduced or diminished) ovarian reserve is an indirect measure of the quantity and quality of eggs or oocytes. If you have low ovarian reserve, then your eggs may have higher risk of having errors during cell division and embryo development. This means it may result in faulty splitting of the genetic material between cells. This in turn will create an abnormal embryo that is less likely to implant resulting in failed IVF treatment with your own eggs or miscarriage. This may occur whether you are trying to conceive naturally or after fertility and IVF treatment. Hence, it may be better to consider egg donation or having IVF treatment using donated eggs.
What is the maximum age for women to have IVF or fertility treatment?
At London IVF and Genetics Centre, we treat women up to the age of 52 years. Our fertility specialist will discuss the most appropriate fertility treatment whether using own or donated eggs to maximise IVF success at every attempt. We never underestimate the challenges in achieving pregnancy in women over 40. We work in partnership with our patients to help them make informed decisions at every step. We can help women over 45 years of age in achieving successful pregnancy with IVF using donated eggs. At London IVF and Genetics Centre, we believe in find solutions for our patients that are most appropriate, least invasive and most importantly in keeping with your wishes and beliefs.
How can I find a fertility clinic near me that treats women having IVF over 40?
There are various ways you can seek help for IVF treatment if you are over 40 and want to explore your options. You can speak to your GP about it. You can also self-refer to a private gynaecologist or fertility specialist for consultation and treatment. You can also see fertility specialist or gynaecologist to better inform yourself of the pregnancy risks even before you have started trying.
When choosing a clinic or fertility specialist near you, it is important to enquire their experience in managing women with similar situations. Also, whether the fertility clinic can offer full range of fertility tests and treatments to maximise outcomes in women having IVF over 40.
Book your appointment or join our next open evening
At London IVF and Genetics Centre, we offer a wide range of detailed tests and fertility treatments for IVF over 40 at our fertility and IVF clinics in London and Milton Keynes.
You can call our nearest clinic (Wimpole Street, London: 02075800207; Milton Keynes: 01908915151) or email firstname.lastname@example.org for more information or to book your appointment.
You can also join our next open evening in London to know more about your options and ways in which we can help.