IVF in the 40s for post-40 fertility

INTRODUCTION:

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Compared to women younger than them, women over 40 have a reduced chance of becoming pregnant. They also have lower success rates in fertility treatments, including IVF (in vitro fertilization).

The quality of eggs is a key factor in reducing success rates for couples trying to conceive on their own. IVF is a treatment that uses eggs to produce embryos. The problem with IVF is egg quality as well as egg quantity.

Age limits for IVF Treatments

The majority of US IVF clinics allow IVF treatment with “own eggs” up to age 49. However, some programs will continue to do it even after that.

What Does Egg Quality Have to Do with Fertility and IVF?

The most important factor in determining the quality and quantity of an embryo is its egg quality. We hope to obtain multiple embryos through IVF so that we can select the best from the group and transfer them back into our uterus.

The egg’s chromosomal condition is a major factor in determining its “egg quality”. As women age, the rate of chromosomal anomalies in eggs (and embryos) rises. Around 30% of eggs are chromosomally defective by age 30. About 60% of eggs are abnormal by age 40, and 90% at 44 years.

The preimplantation genetic testing for aneuploidy can be used to check embryos for chromosomally abnormalcy (euploidy), before transferring them into the uterus. Average chromosomal analysis following PGT-A has a high chance of implantation and live birth.

How does egg quantity affect fertility and success rates of IVF?

Statistics on In Vitro Fertilization Success rates by Female Age – and after Age 40

• Below are charts that illustrate live births by embryo transfer procedure based on the recipient’s age.
• Data shows that IVF success is affected by the age of women.
• These fertility and age statistics do not relate to IVF success. However, the general population is experiencing a similar decline in fertility.

These graphs are taken from the 2014 ART Failure Rates Report published by the CDC (Centers for Disease Control and Prevention), a US government agency. This report was based on national data from approximately 450 clinics and more than 200,000 IVF cycles.

The green line indicates IVF success rates with the infertile woman using her own eggs

The blue line indicates success rates with donor eggs

The graph shows that infertility increases with increasing female age.

• Beginning at age 30, the decline in live birth success rates begins to occur.
• The curve gets steeper as eggs decrease in quantity and quality faster, starting around age 38
• Nearly all babies are born via IVF with a woman’s eggs at age 44 and older
• Over 44 eggs have a success rate of 1%.

This also shows that IVF success does not decline with age.

• It is crucial to understand the age of eggs.
• It is not important to know the age of the uterus that carries the embryos.

The CDC has released statistics on in vitro fertilization success for those aged 40 and over.

The graph shows the USA’s average 2014 IVF live birth rate.

Below 35 years old: 37% live birth rate per cycle

Age 41-42: 10% live birth rate

Age 43-44: Live birth rate of 4.4%

The graph by the CDC zooms into national average IVF statistics in 2014 for women over 40 years old

In red, you can see the IVF live birth rate for each age.

Age 40: 16% live birth rate

Age 43: Live birth rate of 5.5%

Over 44 years old: Live birth rate of 11%

Age Limits for In Vitro Fertilization

All clinics have an upper age limit, after which they cannot perform in vitro fertilization with the woman’s eggs.

IVF age limits may vary from one program to the next.

• Most programs in the US have a minimum age of 42 to 45
• For women over 45 years of age, the IVF live birth rate for IVF is less than 1%. Our age limit for IVF with our eggs is 45. After that, there will be no IVF with our eggs.
• Many IVF clinics allow women to receive donor eggs until they are 50.

An egg of low quality and dark color, with an irregular shape, from a 41-year-old. The egg is the ovoid structure at the center that is surrounded by hundreds of ovarian cumulus cells.