With stories of 45 year celebrities having babies (and sometimes even twins and triplets) with high tech treatments, most people think that age is not a barrier to successful treatment. When using donor eggs from a young egg donor, that is definitely true. The chances for success with donor egg ivf is excellent, even for women in their late 40’s. However that is not the case in women using their own eggs. Pregnancies in women undergoing fertility treatment without the use of a donor over 45 are very unusual. A recent report from Florida describes a 46 year old woman who is reported to be oldest woman to conceive from IVF with her own eggs. Is this a major breakthrough? Not really. The main determinant over whether a fertilized egg will develop into a healthy baby is whether the embryo is genetically abnormal. Genetically normal embryos are common in 25 year olds but pregnancy rates are never 100%. Likewise, the vast majority of 45 year olds’ embryos are abnormal, and so the pregnancy rates would be expected to be quite low but not exactly 0%. When confronted with these odds, most couples would chose not to try.
One Australian Fertility Specialist says yes, the classroom is the perfect place to learn about this, as reported on Yahoo News 7. Surveys continually show that the public, both women and men understand very little about their own fertility, and this is perpetuated in the media by stories of miracle late life pregnancies. Many women understand very little about how their own reproductive systems work, and even less about the true effect of age and lifestyle choices on their ability to have a family. Most of us reproductive specialists see patients all the time whose infertility could have been prevented. This doctor in Adelaide sees education as a sort of preventative medicine for infertility and is advocating making fertility education a part of the school curriculum in his country, along side with contraception. Will it work? And could it happen here in the US?
As a fertility specialist, one of the most devastating diagnosis I can deliver to a patient is that she has ovarian insufficiency or ovarian failure, essentially meaning that she in premature menopause. While these women are usually able to bear children with the use of donor eggs, the chances for pregnancy with their own eggs are extremely low. As highlighted in a recent issue of Time magazine, researchers at Stanford have attempted to reinvigorate their ovaries using a procedure called In Vitro Activation (IVA) . Of the 27 couples in trial, 2 actually became pregnant. While the odds for pregnancy were quite low, this represents a glimmer of hope for women with ovarian insufficiency.