Pregnancy after 40 is a fairly rare occurrence even if you try to conceive naturally. IVF can be a possible solution to this problem for women over 40.
The ability to get pregnant, bear and give birth to a child is determined by the age of woman planning to become a mother.
The pace of modern life involving women’s active social and professional position leads them to delay pregnancy until 35-40 years. Education and career growth come to the fore. Sooner or later women decide to expand the family and start to seek a help from fertility specialists. The fertility specialists advise them to undergo in-vitro fertilization (IVF) procedure.
For a woman after 40 years a possibility of the natural conception and normal pregnancy decreases year after year. Most women who are interested in whether it is possible to get pregnant naturally at 45 years receive a negative answer from their doctor. This is primarily due to the natural decrease of the functional activity of the sex glands and organs of the reproductive system. Nowdays there is an opportunity to prolong a reproductive period due to the development of medicine and the pharmacological industry. Sex hormone stimulating drugs have been created; there are drugs to replace them. Doctors incorporate the latest scientific achievements, research and high-quality equipment. So won’t it really help to get pregnant to those who want to have a baby so much?
Modern ART and IVF come to help patients over 40. Such methods are actively used in AltraVita center. The ovarian reserve assessment is required to determine a possibility of getting pregnant with own eggs to woman over 40.
For this reason the following options are used:
At this age IVF is often performed in natural cycle, because a large number of eggs cannot be obtained during a stimulation. Follicular tissue does not give a sufficient response to the stimulation. In addition, if patient has a reduced ovarian reserve, this can lead to a complete depletion of the ovaries. Then pregnancy will be possible only with the use of donor egg, and many women are totally against it.
Although, the embryo obtained in the result of fertilization of donor egg with husband’s sperm, has a half of the loved one’s genotype and woman may feel herself a mother when she bears this child under her heart. The important thing is that the donor is carefully examined and does not have the hereditary diseases and this means that the child will be healthy.
Popular IVF programs
Frozen embryo transfer is considerably less complicated than the classic IVF program. It consists of three stages: getting the endometrium ready, transferring the embryos and maintaining the luteal phase.
Frozen embryo transfer is one of ART techniques.
Basically, it is an in-vitro fertilization program minus the stimulation stage. This technique is advisable when the IVF protocol for some reason was unsuccessful. By preserving the embryos, the parents receive a kind of moral support boost, because even if the first try fails, there is always a second chance. Besides, it will be easier and a lot cheaper.
Many couples choose to tray frozen embryo transfer program after a successful IVF attempt to have a second baby.
The end result of this technique depends on various factors which include:
Some scientists claim that the high dosage of hormones that women are injected with during the stimulation can alter the qualities of their endometrium and may have negative effect on its ability to accept and nourish the embryo.
If the patients use the frozen embryo transfer program, there is no need to do take hormones in such high doses, which makes this program closer to the natural way of things. Consequently, the pregnancy is likely to go more smoothly from the physiological point of view.
Is it necessary for the father to do a medical check-up with this protocol? Yes, it is. Even though he is not actually involved in the process of the transfer and has done the required tests during the first cycle, the frozen embryo transfer recommendations list does contain several obligatory examinations. As for the mother, out of all the usual hormone level exams she only has to do the progesterone blood test, because this hormone is prescribed to ensure a healthy pregnancy.
Sometimes, though fairly rarely, the usual superovulation stimulation protocol is still required to prepare the endometrium for the transfer. This happens when there is no natural ovulation and if the standard preparatory procedures yielded no results.
Regardless of their education level, many people still consider embryo cryopreservation a dangerous procedure that has the potential to harm their future baby. Sometimes, it may be hard for the parents to understand this process. These couples would rather dispose of their spare embryos, which is completely unnecessary and unfounded, just because they are afraid to freeze it.
However, it is essential to realize the difference between a common freezing and cryopreservation. When you freeze something the usual way, the water in the issues crystalizes under the influence of low temperatures and destroys the cell membranes. Cryopreservation in liquid nitrogen happens at the ultra-low temperature of -196 С°. Under these conditions, the ice simply does not have enough time to form. After they are defrosted, more than a half of all embryos can be successfully implanted into the womb tissue and start developing there. Out of 100 frozen embryos, only 5 or 6 of them are lost. Studies have proved that in those cases the cause of death is not related to cryopreservation, but is normally of genetic origin. Large-scale case studies have also demonstrated, that children born from frozen embryos are not any different from other children in terms of general health and course of development, and the pregnancy is usually less problematic. It might be connected to lower amount emotional stress for the parents.
Frozen embryos can be preserved for a very long time. An additional prove to that is the birth of a girl named Emma in 2017. Her embryo has been cryopreserved for 25 years, since 1992. The only condition is to strictly abide by the rules of cryopreservation and defrosting procedures.
In Altravita we use various ART techniques. Thanks to high-level equipment and the skills of our doctors, we keep our statistic results up to the highest standards. You can get more information about cryopreservation from our gynecologists. Call the clinic using the phone number on our website and make an appointment.
Call the clinic using the phone number on our website and make an appointment.
What is IVF in natural cycle? Ultrasound monitoring of growth of the dominant follicle in the ovary of the patients with preserved ovulation.
With a follicle size of 18 mm, either under the control of an ovulation test, or after the intramuscular injection of an ovulation trigger, a follicle is punctured to obtain an egg. The rest of the IVF program process remains the same.
To increase the effectiveness of IVF, the program includes the study of egg’s spindle apparatus. This procedure is carried out on a special apparatus called Poloscope, which allows to examine the spindle, identify defects that can subsequently lead to the development of chromosomal abnormalities. The usage of this technique can increase the chances of implantation and pregnancy and minimize the risk of miscarriage and the birth of a sick child. The rest of the IVF program process remains the same.
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A woman's fertility is highest between the ages of 18 and 29, when most of the menstrual cycles are ovulatory. That is, almost every month the ovum ripens in the ovaries and, when favorable conditions are created, conception is possible. With age, the number of ovulatory cycles decreases significantly, and the chances of getting pregnant fall.
Unfortunately, the probability of a natural pregnancy is not too high. By the age of 40, it does not exceed 10-15%. At 50, the odds are close to zero. Although world history knows many cases when women became pregnant and gave birth to children at 50, and even at 60, these are only exceptions to the rules. For an average woman, conceiving after 40 years without resorting to medical care is almost impossible.
In addition, with age, the risk of developing chromosomal abnormalities, various birth defects, for example, Down syndrome, cerebral palsy. According to world studies, if women aged twenty-nine years of age and older have birth defects in approximately 4-6% of cases, then after forty, they appear in 9%.
What to do, how to deal with this problem? In such cases, modern ART will come to the rescue. In particular, good reviews of IVF at this age indicate that it is quite possible to achieve pregnancy in this way.
Unfortunately, in addition to decreasing the number of ovulatory cycles with age, health problems may arise that affect, if not conception, then pregnancy. That is why doctors recommend not delaying the birth of a child. But if this still happened, first you need to find out whether a woman can become pregnant and bear a baby.
The possibility of a natural pregnancy depends on many factors:
If a woman wants to become pregnant, the specialists of our clinic will prescribe an objective study, the purpose of which is to find out the criteria that affect the possibility of fertilization and the subsequent normal course of pregnancy and childbirth.
They allow you to determine if there are any contraindications to pregnancy. Then begins preparation for the in vitro fertilization protocol.
Assessment of the general condition of the body is necessary, since during pregnancy, the load on many organs increases: the heart, kidneys, etc. The hormonal background changes, immunity decreases. All this can lead to the development of various complications in the mother and the fetus, then a pregnancy that is so hard may have to be interrupted for medical reasons, which will become not only physical, but also emotional trauma for the patient.
In preparation for IVF after 40 in clinic "AltraVita" may be assigned such examinations as:
If necessary, the study of a man to diagnose the possible presence of infertility in him is included in the diagnostic process and determining the possibility of a woman becoming pregnant. At a minimum, the spouse must pass a spermogram. Based on its results, the issue of conducting additional diagnostic measures are considering.
The condition of the ejaculate is also important for choosing a program. So, in case of impaired sperm motility, the appearance of pathological forms in the sperm, it may be necessary to conduct morphological selection of the sperm and intracytoplasmic injection (ICSI).
If criteria are found that sharply reduce the possibility of conceiving a baby and the normal course of pregnancy in a woman, the center’s doctors can recommend an IVF program after 40 years.
Natural conception is a matter of chance, which often depends on many factors. Even if you accurately determine the day of ovulation and create all the necessary conditions for fertilization, conception may not occur.
During the IVF protocol, stimulation of ovulation allows you to take several eggs. And if some of them do not fertilize, it remains an opportunity to get a full-fledged embryo for transfer to the uterus.
Another problem for those who decide to become pregnant after 40 years old is the risk of having a sick baby. The likelihood of a newborn having Down syndrome and other pathologies at this age increases sharply. In vitro fertilization, it is possible to select high-quality embryos using PGD.
Which not only reduces such risks, but the woman does not lose valuable time, because with age new problems and diseases may appear. And an extra psychological trauma due to failure can also affect a woman's condition.
According to the studies of scientists from the University of Adelaide, who analyzed more than 300 thousand natural births and 3600 in vitro fertilization procedures in age-related patients, interesting data were obtained. It turns out that birth defects in "test-tube babies" appear much less frequently in 3.6% of cases than in naturally conceived children at this age. This figure is even less than that of women in labor over 29 years of age. That is, after forty IVF is not only effective, but also reduces the risk of developing abnormalities in the fetus.
It has been suggested that the drugs used in the protocol have a positive effect. Although an important role is played by the careful selection of planted embryos.
Indeed, in life, many pregnancies are interrupted at such a short time that women do not even notice it. Embryo tissue is excreted with menstrual bleeding. So nature gets rid of embryos with serious pathologies. And with artificial insemination, the highest quality germ cells and embryo for replanting are selected.
After a comprehensive study, the doctor can determine one of several options for the data of ART and IVF after 40 years:
Sperm injection into the cytoplasm of the egg (ICSI), followed by implantation of the embryo on the mucous membrane of the woman’s uterus. It is quite common and in many cases allows a successful IVF after 40 with its own egg.
Surrogacy - if for various reasons IVF at the age of 42 with your egg is impossible, and pregnancy is contraindicated for a woman.
Comprehensive diagnosis data suggest not only an assessment of the fertility of the couple, but also the absence of contraindications to the procedure and pregnancy. The main ones: mental abnormalities, somatic diseases that prevent bearing, genital gland pathology, deformations and abnormalities in the structure of the uterus, a cancerous tumor of any localization. A relative limitation is inflammation and benign masses in the genitals.
The specialists of our clinic try to carry out in vitro fertilization with their own egg, even at the age of 45, if possible. Usually a natural cycle is used with minimal stimulation, which allows to minimize the adverse effect of hormonal drugs on the body.
But problems with age arise not only in women, but also in men. In such cases, IVF with ICSI is used. In the AltraVita clinic, to determine the effectiveness of the protocol and reduce the risk of developing chromosomal abnormalities in the fetus, a technique for determining the spindle is used. Thanks to special equipment, it is possible to visualize the spindle elements and conduct ICSI without risking damage to it.
After successful fertilization, preimplantation genetic diagnosis is prescribed in age-related patients. It eliminates mutations and congenital malformations during IVF after 40, the risk of which increases with the age of the expectant mother. PGD is carried out before the implantation procedure and consists of a biopsy of the embryonic cells at the stage of zygote division (fertilized egg cell). A single blastomere is usually taken for research. The main advantage of this diagnosis is that there is no need for an abortion and high chances of having a healthy baby without genetic abnormalities.
If it is not possible to get a quality egg from the mother, we suggest using a donated egg for fertilization. The results of studies show that the use of donor material in women aged gives very good results. If the usual protocol is successful in 26-30% of cases, this indicator is lower than in young patients, then in IVF with a donor egg, pregnancy occurs in 49% of cases.
It is still not well understood why this type of program gives such high results, but studies by scientists from different countries confirm this, as well as the long-term statistics of our clinic.
That is why our experts advise not to waste time on new attempts, but to use donor material in such cases:
Altravita Clinic has its own cryobank and a large donor base, from which you can choose the most suitable candidate. Our experts will provide all the necessary information about the donor (eye, hair color, constitution, nationality, education, etc.).
We also have a surrogate mother database, if during the examination it turns out that pregnancy is contraindicated for a woman. All candidates are thoroughly examined, have their own healthy children.
Thanks to the use of the latest approaches in the treatment of infertility and ART, doctors at AltraVita clinic often manage to get positive IVF results after 40 years. Contact our center. With a high probability this will allow you to become pregnant even at a late reproductive age.