Meeting or beating the age barrier of infertility

Meeting or beating the age barrier of infertility

Aging oocytes, advanced maternal age, diminished ovarian reserve…by any other name, these are the ‘labels’ that many women over 35 may hear when they’re not expecting and trying to figure out why.

Yet, in the face of Father Time, it seems as though nothing can be done, particularly when it comes to biology.

I know these discussions all too well. Many women come to us in peak physical condition, looking 10 years younger than they really are. But, your ovaries don’t care. They are programmed by their own clock, one that tends to favor the younger egg.  By the age of 40, a woman’s egg supply is approximately 3 percent of the million eggs she was born with.

Yet, despite what may seem like somber odds, there are methods for beating the clock:

1) Preimplantation Genetic Screening (PGS) – An option when doing Invitro Fertilization (IVF) is to utilize PGS as a means for determining each embryo’s chromosomal ‘health.’ It’s not just the number of eggs that decrease as a woman ages, but the quality of those eggs, as well. By the early 40s, as many as 70-90 percent of eggs will have a chromosomal abnormality which can result in a variety of genetic conditions including Down Syndrome.  Chromosomal abnormalities can also result in an embryo that does not implant or is miscarried.

By utilizing PGS and only selecting the healthy embryos to transfer, the chance of a pregnancy, as well as a chromosomally normal pregnancy, are greatly increased, allowing for parity of outcomes, even when comparing women of different ages.

And since chromosomal abnormalities exist in women of every age (despite increasing over time), PGS can also help balance the odds for any woman to conceive and carry a healthy pregnancy.

2) Egg Freezing

Approved by the American Society of Reproductive Medicine (ASRM) as a non-experimental means of preserving fertility, egg freezing can help women past their reproductive ‘prime’ to conceive. Provided that eggs are frozen at a younger age (<35), egg freezing can offer an ‘insurance policy’ to women whose life circumstances, health etc. prevent them from conceiving a child during their ‘peak reproductive years.’ By no means should Egg Freezing be used as a reason to put off having children. Oftentimes, however, professional, personal or medical reasons make this scenario difficult to impossible. Egg freezing then provides another opportunity to ‘level the playing field’ in later years, allowing a 40-something woman to conceive when eggs that were frozen in her 20s or 30s.

3) Donor Egg

When a woman feels as though she has exhausted her resources (medically, financially or emotionally) to conceive with her own eggs due to age, medical/congenital issues etc., donor eggs provide an opportunity to carry and deliver a child. Studies have shown that even if a woman is perimenopausal or in menopause, she can successfully conceive and carry using an embryo created from donor eggs.

4) The rule of 3s

If a healthy woman, regardless of age, has conceived, and made it out of the first trimester, her odds of the pregnancy resulting in a live birth are almost the same, regardless of age. And the chances to have a good outcome and a healthy baby are very high.  Of course, we still recommend all the routing testing during prenatal care.

Human reproduction is an inefficient process at best, regardless of age. But for those who are entering the process later in the game, it’s good to know that there are options.

Dr. Elena Trukhacheva, MSCI, is one of the field’s devoted female reproductive endocrinologists, who demonstrates a unique rapport and understanding of her patients. As a woman and a mother, she takes pride in providing comprehensive care and strives to bring hope and support to her patients. Dr. Trukhacheva is Board Certified in the specialty of obstetrics and gynecology and in the sub-specialty of reproductive endocrinology and infertility.

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3 Comments

  1. Not to be politically incorrect, but maybe Mother Nature had a reason for ending reproduction around age 40. Speaking as a somewhat older mother myself (my kids were born when I was 36 and 38 respectively), it’s very, very hard to run around after little kids and keep up with active older kids. Not to mention, I’d like to be in good health when my kids gradate from high school and college, get married, have kids of their own, etc. I’d like to actually be able to care for my grandkids, not be some doddering old fool who gets to hold the kids sitting down with supervision.

    Pregnancy is also very hard on a woman’s body, moreso as she ages. If a mother already has kids by age 40, she should really stop and think about the wisdom of having more, with the increased risk of leaving the existing ones motherless given the increasing chances of complications.

  2. Dr. Trukhacheva failed to note that in using PGS, the physician is technically playing God, choosing which children have a chance at life and which do not. This is a slippery slope on which we should not be treading. As a woman suffering from undiagnosed infertility myself, I know well the pains of infertility. However, becoming a mother through adoption has been the greatest gift my husband and I could have ever imagined. I encourage more infertile woman of any age to explore adoption.

  3. I very well the emotional rollercoaster of fertility. i have several IVF failed as a matter of fact I still don’t know what to do. I think I am in denial.

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About the Author

Dr. Elena Trukhacheva
Dr. Elena Trukhacheva

Dr. Elena Trukhacheva, MSCI, is one of the field’s devoted female reproductive endocrinologists, who demonstrates a unique rapport and understanding of her patients. As a woman and a mother, she takes pride in providing comprehensive care and strives to bring hope and support to her patients. Dr. Trukhacheva is Board Certified in the specialty of obstetrics and gynecology and in the sub-specialty of reproductive endocrinology and infertility. She is a part of the Reproductive Medicine Institute Chicago: www.teamrmi.com.

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