IVF in Women after 40
The chances of natural pregnancy decrease significantly with age. Biology is not changing as much as the human mind is changing unfortunately so while there is around a 25% chance of pregnancy per month at the age of 25, it falls too drastically to less than 5% chance of pregnancy each month if the female partner is 40 or overage. Also even when we do the IVF treatment in these patients we know that the IVF success depends on the most important clinical prognostic factor to predict whether IVF will be successful and how much percentage we give to the patient to start with as you can see that when the patient, the female partner, is less than 30 the chances of IVF success are 50% per cycle, but that drops down to nearly 3% to 5% or less than 10% from the time of 40-41 year age whereas as you can see the donor egg, if the eggs are coming from the younger women then the pregnancy rate remains same.
So yes in theory there are but look at the pregnancy rates that how poor they are and so if you try clomiphene, which is an ovarian stimulation drug, which is probably the first-line treatment to offer in the younger age group of women, but in these patients, over the age of 40 the clomiphene will give them only 0% to 4% chance of pregnancy every cycle whereas when you offer them IUI along with the clomiphene their chances are hardly going from 1% to 4%, which is not anything significant benefit by even doing IUI in this group of women. Even when you give them strong ovarian stimulation drugs like FSH and IUI, the chances are not significantly high. It is the only IVF in this group of women which gives them a reasonable chance of pregnancy and live birth which is around 16% clinical pregnancy and 13% is the live birth rate. So this is the latest figure again to emphasize the same thing: from the American Study CDC and the latest data and about the number of cycles they had done in the United States in 20018. As you have seen that when the patient comes from… when you are starting the cycle for oocyte retrieval, ovarian stimulation, oocyte retrieval, more chances you can give them based on the evidence if the female age is less than 35 they have a 52% chance of having a live birth but that drops to 7.6% if the female partners are more than 40.
A few other questions to be answered include:
- What are the challenges of late IVF?
- What are the newer developments in the ovarian stimulation protocol?
- Should ICSI be implemented during IVF in all advanced age patients? Does it improve the outcome?
For detailed answers to these and other questions, you might have on IVF in Women after 40 - Challenges and Clinical Strategies to Maximize Success by Dr. Sohani Verma (MBBS, MRCOG, FRCOG, FICOG, FIMSA, PGDMLS, PGDHHM, FMAS), here, https://docmode.org/ivf-in-women-after-40-challenges-and-clinical-strategies-to-maximize-success-dr-sohani-verma/
