How old is too old to try IVF ?

Pregnant womanWith 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.

Surrogacy- why not to do it yourself

princeton-ivf-turkey-basterLike most Reproductive Medicine practices, we perform what we refer to as “Third Party Reproduction” meaning we use donor sperm, donor eggs, gestational carriers for couples who need these procedures. One of the problems with the use of an egg and sperm donors or surrogates and gestational carriers, is that using them can be rather pricey. A lot of effort is required to make sure all parties involved are protected medically and legally, and so many patients may be tempted to do this at home without medical intervention. This story of a “Turkey Baster” do it yourself surrogacy from the UK illustrates why it is so important not to try this at home.

 

 

UK agency weighs in on three genetic parent IVF

HFEA-Princeton-IVFWith government agencies in the US and UK, considering  allowing the use “cloning” technologies to prevent the transmission of mitochondrial disease, nuclear transfer has become a hot topic in Reproductive Medicine. As discussed in our prior blog post, IVF is used to obtain eggs from both the intended mother and an egg donor, and the nucleus of the egg  (which contain the mother’s genetic material) is transferred into the donor egg (which contains healthy unaffected mitochondria).  British authorities have now issued a draft guidance document recommending letting research proceed on mitochondria donation. What will the USFDA recommend and will this type of research to help couples with mitochondrial diseases  move forward? Only time will tell.

Religion, assisted reproduction and the paradox

world-religions-symbolsOne of the most fascinating things about practicing Reproductive Medicine in an ethnically and religiously diverse area is learning to understand the value systems that our patients bring to the table when they come to seek out fertility treatment. Some faiths such as Roman Catholicism reject Assisted Reproduction as a separation between reproduction and intimacy and others such as Judaism encourage it emphasizing the importance of the biblical commandment “to be fruitful and multiply.” Sunni Islam permits assisted reproduction but forbids the use of donors or gestational carriers. The most fascinating and perhaps most paradoxical is that of Shia Islam, the predominant religion in Iran. Most of the world views the Islamic Republic of Iran as one of the most brutal and intolerant in the world, yet when it comes to Assisted Reproduction, it is actually one of the most open minded. As pointed out in an Op-Ed in the Pittsburgh Post Gazette, Iran’s Shiite theocracy allows relatively unrestricted access to ART and IVF, including the use of egg and sperm donation, a practice forbidden in most of the Middle East. Iran, in fact, now has over 70 clinics, luring patients from Sunni countries that forbid the use of donation.

Weight does impact the chances for IVF success

We have know for years that being overweight can affect fertility and lower success rates for infertility treatments such as IVF. Some centers have even set weight limits on IVF treatment for this reason. However, it wasn’t clear if being overweight was harming the eggs or making the uterus less receptive to pregnancy. A recent study from Spain found that overweight patients had lower pregnancy rates even when they got eggs from a normal weight woman, meaning that this effect is due at least in part to a problem with the uterus. The take home lesson: weight loss may improve your chances of having a baby even with donor eggs. For more information from Dr. Sanjay Gupta’s Guide, click here