27 May 2020
Many couples are increasingly putting off having kids until they have achieved certain career and financial goals. This means that many end up waiting to actively try for a baby until they are in their late thirties and forties. However, for women, in particular, this delay can be problematic as fertility tends to decline as we age.
Although male fertility will also matter, success in conceiving a child will majorly depend on the quality of eggs that a woman can produce. As women age, the quantity and quality of eggs they can produce will decline. The steepest decline occurs after the age of 40, hence the reason many clinics that provide fertility treatments will prevent female patients from using their own eggs to conceive a child from around the 42-45 age range. Depending on the limit they set, patients older than this may be required to make use of donor eggs from younger women.
Older women are more prone to having eggs that have chromosomal abnormalities. By the age of 40, about 60% of eggs are chromosomally abnormal. These abnormalities can increase the risk of failed implantation, miscarriages or conceiving a child with chromosomal abnormalities like Down’s Syndrome. Fortunately, there is screening done before implantation of embryos to identify the healthiest embryos and those with abnormalities.
It is due to the decline in fertility that women who wait longer to conceive are advised to seek medical help immediately. Those under the age of 40 are often advised to wait until at least 6 months of actively trying to conceive through unprotected and regular sex fails. Those over 40 are advised to consult with a fertility specialist immediately after they decide to have a child to understand their situation and options.
With fewer viable eggs past the age of 40, there are therefore also fewer quality embryos that can be created through in vitro fertilisation (IVF). This translates into a lower success rate with this form of assisted reproduction when compared to younger women. Women over 40 have a 20% chance of successfully conceiving with IVF treatment, with the rate declining as they get older.
Given the concerns listed above, it can be difficult for a woman over the age of 40 to successfully undergo IVF treatment with her own eggs. To help these odds, many clinics will set an age limit. This age limit can be anywhere between 42-45 years.
Regardless of the potential issues with eggs in women in their 40s, it is still recommended they try their own eggs first. The process can still be successful in many cases and the pregnancy will be monitored throughout. We usually recommend a donor’s eggs after it becomes clear that using your own eggs won’t work.
So, being 40 years old does not make it too late to try IVF treatment. You may have enough viable eggs that can be used to make healthy embryos and conceive your own biological child. If you later want more children, you can have the remaining healthy embryos cryogenically frozen for later implantation.
Your fertility and chances of successfully undergoing IVF treatment can improve drastically if you shed excess weight. This is because if you carry too much weight, it can make it more difficult to monitor ovaries to pinpoint the best time for egg retrieval and can complicate the procedure. Consulting with your doctor or a dietician to work out dietary changes you can make and incorporate an exercise program can greatly help.
Conception rates can be affected by stress. Right from even the ovarian stimulation stage, your stress levels can affect your pregnancy outcome. Try to find activities or relaxation techniques that can reduce your stress, despite how stressful this process can be. Whether it is exercise, massage, acupuncture, breathing exercises, a mini-vacation, or mind-body programs, find out what you can do to relieve the tension and try it.
Smoking has a negative impact on physical health that can in turn affect IVF success rates. It can impact both egg and sperm quality, making it vital to quit the habit as a household. Drinking alcohol can also negatively impact the chances of successful fertilisation and the ability to attain a live birth. It may also affect fertility rates. Cut out both habits and try to maintain as healthy a lifestyle as possible to increase your chances of success.
Talk to your primary care physician, or family and friends that have undergone such treatments to find a good fertility specialist to work with. It needs to be someone who you feel comfortable around and can take direction from. Look into their success rate and ensure they are suitably licensed and equipped for the work they claim to do.
If not using donor sperm, then the male partner also has his role to play in improving sperm quality. Just like the woman, attaining a healthy body weight can help. If during evaluation sperm quality is a concern, the fertility specialist may be able to prescribe certain medications and supplements that will help to boost sperm quality and quantity.
Before pursuing IVF treatment, try to achieve and maintain a healthy lifestyle. The healthier you are physically, for both the male and female partner, the better the chances of success. However, it is not uncommon for even healthy couples to need more than one round of IVF to successfully achieve a live birth. It is important to not become discouraged by setbacks, especially if you have been doing everything right, and keep following the advice of your specialist. Try to remain patient and persistent to achieve what you want.