Is Fertility After 40 A Pipe Dream?
Many consider the 20s the peak of life. Energy levels are highest, and so is physical strength. During this decade, fertility is also at the highest. Like everything else, with age, fertility reduces significantly, especially after 40. For instance, there is a 5% fertility chance for an average healthy woman over 40. At that age, many women and men alike feel that all hope is lost. However, there is hope with in vitro fertilization (IVF). According to the Centers for Disease Control and Prevention, first-time births among women ages 40-44 have more than doubled between 1990 and 2012.
What happens as we age?
The reproductive abilities of men and women alike change dramatically with age. Women are born with a set number of follicles that become eggs. These eggs decline over the years thanks to menstruation. By age 40 and beyond, the egg quantity and quality make pregnancy difficult. Men have a larger window than women. However, sperm quality and quantity also decrease. Men are also more likely to suffer from lifestyle conditions that affect fertility. Luckily, medicine and assisted reproductive technology allow people over 40 to consider different options to get pregnant.
Starting with fertility drugs
Before trying procedures that may help a woman conceive, a doctor will first prescribe fertility drugs. These medicines help the body release more hormones that will trigger or regulate ovulation. Sometimes, these drugs also boost the success rates of another fertility method, like intrauterine insemination (IUI). Medication may have some risks like ovarian hyperstimulation syndrome. However, these drugs can help success rates after 40.
Turning to in vitro fertilization
IVF or in vitro fertilization is the most widely used fertility procedure for couples over 40. With IVF, eggs are retrieved from the woman’s ovaries and then combined sperm to form an embryo. The embryo will then be implanted into the woman’s uterus or frozen for future use. From there, the doctor and woman monitor for pregnancy. IVF has several additional steps to improve success rates. For example, intracytoplasmic sperm injection (ICSI) helps infertile men by using one sperm to fertilize the egg. Other techniques include assisted hatching and preimplantation genetic testing. IVF success rates for couples over 40 are at 13-18%.
Egg donation and FET
To further increase the success rate of IVF, the best option would be to use a donated egg, sperm, or embryo from a younger donor. Some women over 40 performed embryo freezing at an earlier age to prepare for this moment. The donated egg or sperm will then go through the same steps as IVF. A frozen embryo transfer (FET) works the same way and has fantastic results. In fact, by using a donated egg or FET, the success rate increases by 35%. However, in the case of donor eggs, the woman will not have any genetic connection to the child.
Turning to surrogacy
Surrogacy is the process where another woman carries the parent’s embryo to full term. With traditional surrogacy, the surrogate will be artificially inseminated with the hopeful father’s sperm. The surrogate will then carry the baby until the delivery. Gestational surrogacy uses IVF, wherein the eggs and sperm are retrieved and combined to form an embryo. Then the embryo will be transferred into the uterus of a gestational surrogate. Surrogacy is an excellent choice for couples over 40 with medical issues, same-sex couples, and those struggling to become pregnant.
Want to conceive? Talk to your doctor
Getting pregnant after the age of 40 is possible yet will be challenging. Make sure to immediately visit a gynecologist for an evaluation, especially for those closer to 40. The next step will be a basic fertility test and blood test to determine current hormone levels. These will determine the risk for infertility. From there, discuss different fertility methods, including IVF, and how to increase the chances of conception.
