- Age and Fertility
- CDC Report on Fertility Clinic IVF Success Rates
- Chromosomal Abnormalities in Eggs
- Donor Eggs
- Egg Banking
- Egg Donation
- Egg Donation Cost
- Egg Freezing
- Egg quality
- Embryo freezing
- Embryo implantation
- Fertility Preservation
- Frozen embryo transfer
- IVF Clinic Success Rates
- IVF Cost
- IVF Poor Responders
- IVF success rates
- Low ovarian reserve
- Micro IVF
- Mild IVF
- Mini IVF
- Minimal Stimulation IVF
- Number of IVF Embryos to Transfer
- Oocyte Cryopreservation
- Ovarian Reserve
- Ovarian Reserve Tests
- Preimplantation Genetic Screening
- Single Embryo Transfer
Fertility, IVF and Egg Donation
Age and female fertility and waiting to have babies
- A recent report on the average age at first childbirth from the CDC’s National Center for Health Statistics showed that as of 2006, women in the US waited an average of 3.6 years longer to have their first baby, as compared to 1970.
- There is not enough discussion in our society about the effect of age on fertility.
- Women’s liberation is a good thing and women have made very significant advances over the past 40 years. Many women are pursuing advanced education and careers.
- However, there is a potential “disconnect” involved. Women are waiting longer to have children – but many are not educated about what that delay can do to their fertility.
These days, many couples try to have their first child when the woman is in her mid-to-late 30s. Some will get pregnant easily, and others end up needing fertility treatments. It is not uncommon for me to see a couple with the woman in her early or mid-40s who say that they had no idea that getting pregnant would be a problem. These are educated and intelligent people. Maybe they were not exposed to the right information about fertility and aging – or maybe they never paid attention to it.
- As the American Society for Reproductive Medicine has pointed out: “As women delay childbearing, there is now an unrealistic expectation that medical science can undo the effects of aging”.
- We try our to overcome the effects of age with advanced treatments such as in vitro fertilization. But IVF success rates decline significantly with advancing female age.
What causes fertility to drop with age?
- Success with fertility treatment using the woman’s own eggs is closely tied to her age.
- When using donor eggs, the recipient woman’s age is not important. It is then the egg donor’s age that matters.
- This tells us that the age of the egg is important and the age of the uterus is not.
- Because of declining egg quality, chances for successful pregnancy begin dropping in the early 30’s and usually drop faster in the mid-30’s (by about 36-37).
- For many women there is little or no fertility potential left by about age 40, and very few women over 43 are fertile.
Even with aggressive fertility treatment (such as IVF) success rates are very low by the mid-40’s. In 2006, the national average for live birth success rate in women over age 44 using their own eggs was less than 1% per attempt (CDC data). Miscarriage rates also increase significantly with advancing age.
Both the fertility decline and the increase in miscarriages are largely due to increased rates of chromosome abnormalities in eggs as women age. Research has shown that a structure called the meiotic spindle in the microscopic eggs in the ovaries becomes damaged with aging. The spindle is involved in organizing pairs of chromosomes for proper division into 2 sets during maturation of the egg. An abnormal spindle can cause disordered chromosome arrangements in the mature egg – and therefore in the embryo.
Can we test the quality or quantity of eggs in a woman?
Since we know that the issue causing fertility problems as women age is declining egg quality, it would help to have a test to check how good a woman’s eggs are. Unfortunately, there is not a good test for egg quality. A woman’s age is the best “test” for quality.
There are screening tests for “ovarian reserve”. However, these are tests of quantity rather than quality. Ovarian reserve tests include:
- “Society” and the medical field should do a better job educating women about declining fertility with advancing age.
- If women are making a conscious choice to delay childbearing and understand the fertility implications – then at least they make a conscious choice.
- However, if they go to their doctor annually for a checkup – at some point (early to mid-30’s) there need to be discussions about declining fertility potential.
PGD – preimplantation genetic diagnosis (or PGS) – does it help to test the chromosomes of IVF embryos?
Welcome to the
Richard Sherbahn, MD is a Board Certified Reproductive Endocrinology and Infertility specialist.
Dr. Sherbahn founded the Advanced Fertility Center of Chicago in 1997.
He will post regularly about fertility issues.
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- Advanced Fertility Center of Chicago
- American Society for Reproductive Medicine
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