The age of a woman is one of the most important predictors of fertility outcome, particularly when it comes to assisted conception.
We know that as women age it can take longer to conceive naturally and certainly when it comes to fertility treatments, the success of that treatment will very much depend on the age of the eggs.
It does not mean that women who are older cannot achieve a pregnancy but what is meant by ‘older’ and why is age so important?
Whilst there is no doubt that success rates from IVF treatments have increased over the years, success rates for women over 42 are still low.
Below shows recent data published by the HFEA for the birth rate since 1992 in women of different age categories.
It has been clearly shown that as women age their eggs age with them and older eggs become less competent at creating chromosomally normal embryos that either do not implant or implant with a higher chance of miscarriage.
IVF is certainly not a treatment for age but may still be a suitable option for some women even over 42 dependent upon their ovarian reserve. When undertaking IVF treatment the number of eggs it is possible to collect in a cycle is hugely determined by the ovarian reserve as determined by the AMH value. AMH is a simple blood test and provides an excellent guide to the potential egg number. Once eggs have been collected approximately 60-70% will fertilise of which approximately 40% will become a blastocyst embryo suitable for transfer. Thus if 10 eggs are collected there will possibly be 2-3 embryos available for transfer. Of those embryos even in women at 37 years of age up to 50% will be chromosomally abnormal. By 40 that number has risen to 62% and by 42 to 75% and by 45 it is close to 90%.
So, If women wish to use their own eggs in IVF treatment over 42 then it is important they have a good ovarian reserve to make it a more viable option. Even then, there is no guarantee of a live birth and it is important that older women are very realistic about the chance of success and are fully informed of their options.
Egg donation is a very successful option for older women to consider but understandably is not for everyone and counselling is strongly advised/encouraged to work through the implications of this alternative treatment.
Having a consultation to go through potential options and individualisation of treatment is the most important first step and older women should seek guidance sooner than later