IVF At Any Age?: A Look at the Medical Dilemma
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Joe Conaghan, PhD, HCLD is internationally recognized for his work with human embryos and brings nearly two decades of experience in human embryology to the Pacific Fertility Center. More about Dr. Conaghan · Read Other Posts |
In the press today we see that the “world’s oldest new mom dies” at age 69 (see our earlier blog post clarifying that PFC did not treat this patient), three years after giving birth to twins conceived through IVF. Maria del Carmen Bousada apparently lied about her age to the Los Angeles Physician who helped her become pregnant, creating a firestorm of criticism in the press.
The case demonstrates one of the most basic dilemmas that we face in helping women become pregnant: at what age is a woman too old to become a mother?
Most of us might agree that a 25 year old woman is young enough to receive help, but that a 70 year old is too old. However, drawing the cut-off line at some point between these extremes is not easy. With the help of in vitro fertilization and donated oocytes, women like Maria can become pregnant at an age where nature would naturally prevent the possibility of conceiving. Typically, women run out of oocytes in their early 50’s and without oocytes and the granulosa cells that surround them, they lose their ability to make estrogen. This natural process, called menopause, can happen earlier or later for a given individual, but the ability to get pregnant and deliver a healthy baby declines rapidly for women in their late 30’s and on into their 40’s. The age of the woman is a determining factor of her since a 40 year old woman is trying to get pregnant with a 40 year old oocyte, and these older oocytes don’t perform well. For example, the older oocyte is not good at keeping track of its own DNA, as evidenced by the increasing incidence of genetic defects such as Down syndrome in older mothers. And as if this wasn’t bad enough, the rate at which oocytes are lost from the ovaries (also know as a woman’s biological clock) doubles at about age 38. If this doubling didn’t happen, we think that women wouldn’t reach menopause until their early 70’s. It is thought that the speeding up of the biological clock in the late 30’s is nature’s way of clearing out the remaining oocytes, so that women lose their ability to become pregnant but are then around to raise the children that they already have.
Based on nature’s model, we might consider limiting IVF treatment to women that are in their early forties or younger. But with donated oocytes, this limit can be pushed and there are no legal age limits for pregnancy. So, who gets to decide when it’s too late to become pregnant? As far as following “nature’s model”, is age different than other factors that lead to infertility? Do we make rules? And do the rules apply to men too, where nature doesn’t have limits?
Note: Pacific Fertility Center does have both lower and upper age limits in place.
Tags: IVF - In Vitro Fertilization, News
July 7th, 2010 at 7:17 pm
give me infor on ivf done at age 42 and over what doctor and where please leave phone numbers my phone is **********
July 9th, 2010 at 3:10 pm
Whether or not IVF is a treatment that would assist you in producing an ongoing pregnancy is a question best answered when more specific information regarding your ovarian reserve is available. Hormone testing can give a good indication as to your ovarian reserve, or potential for pregnancy. In addition, the physician can perform an ultrasound to visualize your ovaries and the number of egg follicles growing there.
IVF can maximize your chances of pregnancy per month. Medications increase the number of egg follicles that grow to the size where they can be fertilized. So rather than just one egg a month being exposed to sperm, there may be many eggs available.
However, the medication can only grow the follicles that are available. The number of follicles available is a function of the biological age of the female. That biology, directed by our genetic code, determines a set lifespan for the eggs. There is also a high correlation between chromosomal errors in the eggs and the advanced age of the female. So even if we can recruit a large cohort of eggs, the question remains as to which of those are chromosomally correct and able to produce an ongoing pregnancy.
Statistically speaking, female fertility begins to decline around age 35. That means over the broad population pregnancy rates drop. Where you are currently in that decline is something our physicians strive to determine. Age is a factor, but we are all individuals within that statistical realm. So even reporting pregnancy statistics for the 42 yr. old may not give you the specific information you seek.
The best way to answer your question is to have your hormone testing done and a transvaginal ultrasound performed by an experienced reproductive endocrinologist.
You can then be given a more precise answer which addresses your specific situation.