In recent years, there has been a tendency towards an increase in the proportion of late pregnancies (after 35-40 years). But it can be difficult for women over 40 to become pregnant naturally. If there is indications for help, the method of in vitro fertilization (IVF) can be performed.
Statistics show that only about 50% of women over 40 are able to become pregnant naturally. After 45 years, the number of pregnancies decreases significantly and fluctuates around 10%. In this case, the endometrium, the norm for conception with IVF must be observed.
The fact is that every woman has her own supply of eggs (ovarian reserve), allocated for life. During each menstrual cycle, a woman's ovaries begin to develop about 100 follicles containing eggs. Usually one of them becomes dominant (the largest) and ovulates; the eggs remaining undeveloped in this cycle never begin to grow again. IVF reasons for failure depend on many factors.
Every month with each menstrual cycle, the supply of eggs decreases - this is a natural process. The quality of the eggs also deteriorates with age. This means that in 40-year-old women, the ability of eggs to fertilize, implant in the endometrium of the uterus and begin to develop normally decreases. The uterus also ages and becomes less capable of carrying a pregnancy with age. In this regard, the risk of miscarriage and missed pregnancy increases. However, due to the physiological characteristics and state of health, the ovaries can function differently in different women and even produce eggs of good quality by the age of 40. AMG for IVF: an acceptable value at which an in vitro fertilization procedure can be performed is the level of AMH not less, than 0.8 ng / ml. If this level is below this indicator, then the quality of the eggs obtained is considered questionable.
Thus, today there are several ways to determine the biological and functional age of the ovaries. These methods help predict the outcomes of IVF infertility treatment. It should also be borne in mind that reduced ovarian reserve values can be the result of inflammatory, infectious and autoimmune diseases. Therefore, samples must be repeated over several months. With persisting low levels of ovarian reserve, you can use donor eggs in the IVF cycle, which allows you to achieve pregnancy and give birth to a healthy baby, even if
Should IVF be done after 40 years? Not a single reproductive specialist will be able to give an unambiguous answer to this question. On the one hand, there are no official prohibitions on the use of assisted reproductive techniques for women over 40. The legislation of the Russian Federation does not impose age restrictions on the use of the IVF protocol in patients. This means that in the absence of contraindications to artificial insemination, a woman of any age can undergo IVF. On the other hand, the list of these very contraindications to IVF at an older reproductive age is significant, since the body of a woman at 40 years old differs from the body of a young girl.
Successful IVF after 40 years is not uncommon, however, a positive result of the procedure can be achieved only if there are no contraindications for bearing a child and the presence of germ cells of the proper quality both on the part of the woman and on the part of the man. Doctor Lazarev A.P. and his team of experienced reproductologists are always ready to select the optimal IVF protocol for patients of any age and with any characteristics.
Conditions for IVF after 40 years
Why are there special requirements for IVF after 40 years? Because this age is critical for the female reproductive system. Egg storage after 40 years is minimal, and some people at this age already have menopause. The natural aging process of the ovaries and age-related changes in the work of the gonads significantly reduce the likelihood of fertilization and successful bearing of the baby. Only 5-10% of patients manage to get pregnant during IVF from the first time after 40 years.
By the age of 40, a woman acquires various chronic diseases, and the supply and quality of her eggs, on the contrary, become lower. If the eggs have matured, most likely the genetic material in them is damaged. Using these eggs for fertilization increases the baby's risk of genetic abnormalities and the likelihood of miscarriage. Among other things, the number of eggs suitable for fertilization, after 40 years, may simply end. That is why successful IVF at the age of 40 is possible only if certain conditions are met.
- Adequate supply of eggs. If you want to undergo IVF with your eggs, the patient must have enough oocytes - germ cells that are able to transform into mature eggs ready for fertilization. You can find out the supply of eggs by undergoing an ultrasound scan or taking a hormone test.
- Absence of somatic diseases that interfere with the normal course of pregnancy. Serious diseases of the kidneys, heart and endocrine system reduce the chance of successful embryo attachment and the development of pregnancy in the future. It is necessary to exclude factors influencing the possible miscarriage of the fetus, which is frequent for age-related pregnancy, as well as the severe course of pregnancy, the development of placental insufficiency.
- The possibility of hormone therapy. Stimulating the maturation of multiple eggs is an important step in the IVF procedure. Contraindications to hormonal therapy or ineffectiveness of stimulation of superovulation reduce the number of embryos obtained during IVF. The doctor determines the effectiveness of hormone therapy based on the examination data.
- The partner's sperm is of the proper quality. When undergoing IVF in adulthood, it is important to have a good quality of not only female, but also male germ cells. The suitability of a man's sperm for fertilization is determined by an analysis called a spermogram.
Features of the IVF procedure after 40 years
Patients who have decided on successful IVF after 40 years should be prepared for an extensive examination. In addition to the usual types of diagnostics required before in vitro fertilization, additional types of examination may be required.
- Follicle counting
Evaluation of ovarian reserve using transvaginal ultrasound is very important for age-related IVF. By counting the follicles, the specialist can predict the chances of success for stimulating the ovaries and producing healthy eggs. - Blood test for hormones
When performing IVF after 40 years, doctors pay special attention to the level of FSH and progesterone hormones. The lower the level of follicle-stimulating hormone, the more eggs the expectant mother has in store. A sufficient level of oocytes is recorded at an FSH concentration of 10 IU / ml and below. - Preimplantation genetic diagnosis
Those who have done IVF at the age of 40 know that technically the IVF procedure is no different from IVF at a young age, except that the number of eggs obtained may be less. However, in some cases, additional manipulations, such as preimplantation diagnostics, may be necessary before fertilization of the eggs. This technique allows you to select only healthy eggs for fertilization, excluding sex cells with genetic abnormalities.
IVF at 40 with a donor egg
Often, successful IVF after 45 years is possible only with the use of donor eggs. If the body no longer produces its eggs or sex cells are of poor quality, have genetic abnormalities and are unsuitable for fertilization, a woman can still undergo IVF, bear and give birth to a baby. To do this, she will be asked to choose an egg donor from the database.
IVF with DY after 40 years is much more likely to bring a positive result than IVF with own eggs of average and low quality. This type of artificial insemination does not involve hormonal stimulation of the ovaries. At the right phase of the cycle, the donor eggs fertilized with the husband's sperm are transplanted to the patient. Pregnancy after IVF with donor material is observed as usual. IVF efficiency after 40 years
For patients in their 40s, IVF from the first time and with a positive result is an infrequent occurrence. The chances that artificial insemination will be effective the first time are only a few percent. But even young patients often have to do IVF several times before reaching the long-awaited pregnancy. This is a normal practice for IVF at the age of 40 - who did it, who didn’t, doctors cannot predict the result of the procedure. Many patients ask: if IVF is done at the age of 40, with what attempt to wait for the result? Most often, in this case, women become pregnant on the second or third attempt. If this has not happened, do not despair. There is always an option to try IVF with a donor egg, this procedure is much more effective than IVF with your own oocytes of low quality.
Doctor Lazarev A.P. works with patients of any age, regardless of the characteristics of their health. For patients over 40, an individual effective program of examination and IVF is always developed. If it is necessary to undergo IVF with donor eggs, the woman will be offered a database of healthy verified donors and help in choosing. Successful IVF after 40 years is quite real.
The use of assisted reproductive technologies does not have strict age restrictions. The possibility of in vitro fertilization is influenced by many factors. It is a mistake to believe that age is the main one.
Performing IVF after 40 with your own egg or using a donor one is an individual question, the answer to which can be obtained only after a thorough examination of the patient. Some women, having learned that IVF can be done almost in the premenopausal period, postpone ART methods. At the same time, they significantly reduce their own chances of a favorable result.
In vitro fertilization is a method of assisted reproductive technology, with the help of which conception is performed outside the female body, after which the formed embryo is transferred into the uterine cavity.
It is assumed that there is a certain age range for the IVF procedure. However, much depends on the additional indicators of the female body: ovarian reserve, hormonal balance, endometrial state and others. Age also plays an important role. It is possible to perform in vitro fertilization until the woman's reproductive function has died out.
For most of the fairer sex, the likelihood of natural conception decreases after 35 years, it becomes more difficult. By the age of 45, the reproductive system functions differently than at 20. After 50, half of women have menopause. It is not possible to conceive and bear a child at this age. However, the efforts and developments of scientists made the impossible, as a result of which the birth of a child conceived in a test tube became possible even by the age of 50.
Numerous observations have established to what age a successful IVF can be done.
Women aged 22-30 have an 80% chance of successful conception. Patients in the age range of 30-35 years old - only 60%. The desire to conceive a child with the help of ART in women under 40 is fulfilled only in 35% of cases. After 40, the probability of a successful outcome continues to decline and is no more than 28%.
Due to the influence of certain factors (heredity, stimulation, hormonal treatment, surgery), menopause may occur earlier. Some patients, already at the age of 30, experience all the signs of climacteric syndrome. In this case, conception is not possible even in a young woman. The average age to which IVF is done is 45 years.
Chances of success after 40 years
Domestic gynecologists and reproductive specialists have nothing against IVF at the age of 40. Theoretically, the procedure can be carried out later. However, the chances of a successful result are reduced several times. If patients under 40 have at least 35% for a positive result, then after 40 the percentage of pregnancies is significantly reduced. The reasons for this result are external and internal factors, as well as their influence on the patient's body. The low chance of success for IVF for women after 40 is explained by the following prerequisites:
- the number of good cells decreases every month, and after 35, the likelihood of chromosomal abnormalities and genetic breakdowns increases;
- hormonal imbalance begins with the approach to menopause, which can affect gestation;
- the risk of termination of pregnancy grows and reaches a maximum after 40 years, statistics show that at this age, every second conception ends in miscarriage;
- unfavorable ecology and bad habits affect health over the years, which reduces the chances of successful conception;
- concomitant diseases in women (hypertension, tachycardia, varicose veins) can cause failures in pregnancy planning and affect embryo transfer.
There is no better age for IVF than 20-35 years old. Range is not the only decisive factor, however. It is necessary to evaluate all the factors in order to talk about the possibility of a successful conception after 40 years.
IVF after 40 years with a donor egg
The chances of IVF success after 40 years are determined. Every woman is born with a certain number of eggs. Gradually, their volume decreases, while initially the best materials are consumed. If menopause has not yet begun by the age of 40, then the ovarian reserve will definitely decrease. It is possible to determine the remaining number of reproductive gametes using complex examinations: a blood test for hormones (FSH, LH, AMH) and ultrasound counting of antral follicles. If the diagnostics show that the amount of genetic material is insufficient and the results of IVF after 45 years promise to be negative, then the method of carrying out the procedure with donor material is chosen.
Numerous procedures for the use of assisted reproductive technologies have shown that it is possible to become pregnant at the age of 44. There are cases when women gave birth even after stopping the work of the ovaries. Since the absence of ovulation during menopause is a prerequisite for hormonal changes, IVF will only work with donor material. It is impossible to predict how the fate of a patient who becomes pregnant after 40-50 years will develop. At this age, many patients suffer from hypertension or diabetes mellitus. Therefore, experts do not recommend delaying motherhood, but recommend that the necessary manipulations be carried out in advance.
IVF after 40 with your own egg
IVF after 40 years has low chances of a successful result. With age, the body wears out, chronic health problems appear, and quality oocytes can no longer boast. Getting good eggs is nearly impossible. If a woman informs the doctor that she plans to do IVF in the future, the reproductive specialist will offer to carry out a procedure called egg freezing.
A cryoprotocol carried out in advance allows IVF to be performed even at 43 years of age and to obtain a successful result. The procedure involves the introduction of a woman into the protocol, stimulation and collection of oocytes, which are then fertilized with the partner's sperm. The resulting embryos are subjected to shock freezing, in which they can be stored for up to 10 years without losing their quality. IVF after 40 with your own egg thawed after cryoprotocol also has risks and disadvantages. Not all embryos can safely undergo shock freezing. Some of the cells still die. Also, cryoprotocol is a rather expensive procedure. Parents-to-be will have to pay for the storage of cells in the bank for the entire period until the time of their replanting.
Up to what age can IVF be done for free under the policy
Previously, the state agreed to do IVF free of charge only if there were certain indications for women under 49 years old. However, in each region, the rules were different and depended on the allocated budget. In most regions of Russia, the IVF quota was issued to women up to 37-38 years old. There were even some municipalities in which the age limit was estimated at 35 years. The age bracket of 43-44 years old was also met, but quite rarely.
However, since 2016, free IVF has no more age restrictions in Russia. To carry out fertilization, a compulsory health insurance policy is required.
There is an Order of the Ministry of Health of Russia dated 30.08.2012 N 107n (dated 11.06.2015) "On the procedure for using assisted reproductive technologies, contraindications and restrictions on their use." All the nuances are spelled out there.
It is important to pay attention to the list of indications and contraindications prescribed by the law. For example, according to the policy, IVF is done only for those women in whom the amount of anti-Müllerian hormone exceeds 1.0 ng / ml, and on the second day of the cycle, more than five are visualized in the ovaries.
So, IVF has the best chance of success in women who are in their prime of reproductive life. For this reason, patients should not postpone pregnancy for a long time and rely on the help of reproductive technologies. Despite the possibilities of modern medicine and the help of experienced doctors, it will be difficult to argue with nature.
Modern medical advances help to overcome the cause of infertility, despite the fact that a few decades ago such a diagnosis sounded like a death sentence. Today, the birth of a genetically related child is possible thanks to assisted reproductive IVF technology. 40 years is the age when a woman has every chance to feel the joy of motherhood. At the same time, as part of the in vitro fertilization program, elderly patients require constant monitoring of the state of pregnancy due to the high risk of miscarriage. It is impossible to achieve successful IVF results in 100% of cases, however, the chances of pregnancy and the birth of a healthy baby are quite high. An important role at this stage is played by the use of a healthy egg for artificial fertilization.
IVF after 40 years: the chances of success when using your own egg
The body of every woman has a certain limited supply of oocytes. With age, the number of eggs decreases, and during the period of menopause, their supply is considered completely depleted. In this case, the onset of pregnancy is possible only with the use of a donor egg. For this, oocytes of young healthy women who have undergone a complete medical examination are used.
Every patient dreams of becoming the mother of a genetically natural child, but not in all cases such an opportunity exists.
IVF at the age of 40, as a rule, is performed using your own egg. The older a woman becomes, the more likely it is to use donor material for an in vitro fertilization program.
Egg cells tend to age, that is, structural chromosome pathologies are observed in them. Such sex cells are not suitable for artificial insemination.
IVF after 40 years using a donor egg: stages
- Donor selection. Donation can be:
- anonymous: the couple has only phenotypic information about the oocyte donor;
- known (non-anonymous): a couple receives donor material from relatives, friends, acquaintances.
- age from 20 to 35 years. Otherwise, there is a high probability of genetic abnormalities in the development of the fetus;
- absence of genetic and chronic diseases;
- lack of bad habits;
- having your own genetically natural child;
- the donor woman must not be overweight;
- lack of vivid phenotypic features;
- absence of violations in the work of organs and systems of the body; no contraindications to hormonal stimulation and follicle puncture.
A girl who meets the following criteria can become an anonymous donor:
Information regarding the anonymous donor is confidential. In turn, the oocyte donor does not have information about the pairs for which their eggs are intended. After the baby is born, the donor has no right to the baby.
- Synchronization of the menstrual cycles of the female recipient and the female donor. The main goal of synchronization is to achieve a certain degree of maturity of the endometrium of the female recipient's uterus for successful embryo implantation. Synchronization is possible in the natural cycle, or is achieved with the use of hormone therapy. It is mandatory to monitor the state of the ovaries and endometrium using ultrasound monitoring, as well as through the results of a blood test for hormone levels.
- Stimulation of superovulation from a donor woman to obtain several mature eggs at the same time.
- HCG injection(human chorionic gonadotropin) to the donor woman 36 hours before the expected ovulation.
- Endometrial preparation female recipient for embryo replanting using estrogen.
- Follicle puncture donor and egg collection.
- Oocyte fertilization sperm outside the woman's body in the conditions of the embryological laboratory.
- Embryo cultivation within 3-5 days.
- Embryo replanting into the uterus of the recipient woman.
- Prescribing supportive hormone therapy.
IVF after 40 years: possible protocol options
The doctor chooses the in vitro fertilization program for each patient depending on the individual characteristics of the woman's body and the results of the examination. In this case, the earlier protocols, the presence of cryopreserved healthy embryos, contraindications to hormonal stimulation, the general health of the patient, and a number of other aspects are taken into account.
As a rule, with artificial insemination after 40 years, a stimulated IVF cycle or a natural one is used. Each of the options has its positive and negative sides.
In the case of stimulation of superovulation, several mature eggs are obtained at the same time. However, the use of hormonal drugs can have a number of negative consequences, manifested in excessive stress on the liver and kidneys, hypertension, ovarian hyperovulation syndrome. Doses of drugs are prescribed by the doctor to each patient individually. In case of an unsuccessful IVF attempt, the protocol can be repeated no earlier than after two menstrual cycles.
With the natural IVF cycle, after 40 years or at any other age, only one mature egg is obtained, which significantly reduces the likelihood of pregnancy. It is possible to use several eggs (cryopreserved) obtained in different cycles.
In addition, constant monitoring of the condition of the follicles is required. In 10-15% of cases, patients experience spontaneous ovulation, follicle puncture and egg collection in this case become impossible. The cycle is considered complete.
The advantage of the natural IVF cycle is the ability to repeat the procedure in the next menstrual cycle.
Successful IVF results after 40 years
The factors contributing to the onset of the long-awaited IVF pregnancy after 40 years are:
- complete examination of the patient, accurate and thorough diagnosis in a specialized medical institution;
- the correct choice of the IVF program. The patient's ovarian reserve and the state of the organs of the reproductive system are determined;
- absence of concomitant diseases;
- the use of auxiliary additional technologies - pre-implantation diagnostics and embryo hatching, if necessary;
- proper withdrawal from hormonal support;
- spouse's sperm counts are normal.
IVF after 40 years: choice of clinic
The successful results of in vitro fertilization depend not only on the characteristics of the organisms of the future parents, but also on the experience and qualifications of the doctor performing the procedure.
The specialists of the IVF Center in Kaliningrad individually approach the problem of infertility for each couple, have experience working with elderly patients, and consider alternative methods of infertility treatment.
Thanks to assisted reproductive technologies, women aged 40 and over can experience the joy of motherhood.
Women decide on artificial insemination at a mature age, after a long struggle with the diagnosis of infertility with a medical method, with the help of surgery. Also, in many cases, these girls, being at a young age, did not dare to have a child due to financial insolvency. The achievements of modern medicine allow adult women after 40 years, and in some cases even after 50 years, to bear and give birth to an absolutely healthy baby.
The older the woman, the lower the chances of successful IVF and the higher the risk of miscarriage. In addition, pregnancy is stressful for the body of the expectant mother and is accompanied by an increased load on all systems and organs. Before deciding on such a crucial step as in vitro fertilization, you should undergo a full examination, pass a number of tests, listen to the recommendations of a specialist, weigh the pros and cons, and only then make a final decision.
Despite all the difficulties and possible risks, the joy of motherhood is incomparable with anything. When a couple first picks up a long-awaited and desired baby, they realize that any risks are fully justified.
So every woman at any age can feel the joy of motherhood. The key to success on the way to the birth of a baby is the correct preparation for the IVF procedure and, of course, faith in a successful result.
The realities of modern life are such that, compared with the past century, the childbearing period has significantly shifted. Sometimes, only after 40 years, having achieved success in their careers and equipping their own homes, many couples feel the moral willingness to become parents. They are helped by assisted reproductive technologies (ART), which are improved day by day. THIS is a special IVF technique that allows you to get pregnant even at 50 with your own egg.
- "Stars" who gave birth after IVF
- What are the chances of IVF after 40 years
- Factors that reduce the chance of successful IVF
- IVF chances with your egg and donor
- How to increase the chances of fertilization with IVF
- PGD embryo before "replanting"
- With what IVF attempts it will turn out to get pregnant
"Stars" who gave birth after IVF
In vitro fertilization after 40 years often ends with a positive result - the birth of a healthy child, and sometimes two at once. An example of this is many popular people who became parents only after reaching this age milestone. So, Celine Dion, in order to become a mother for the second time, went to IVF, and after the sixth repetition of the protocol she was able to become pregnant, giving birth to twins at 42 - Nelson and Eddie. Desperate Housewives star Marcia Cross gave birth to twins at almost 45 years old. The singer Mariah Carey also left not far, having given birth to a son and daughter at 41. All the "stars" confidently say: all these efforts, efforts and experiences were worth it to get such a miracle!
What are the chances of IVF after 40 years
In fact, reproductive experts all over the world point out that IVF after 40 years is a very common practice.
Of course, the chance of its success is less than before the age of 30, nevertheless, it is available:
- The supply of follicles - the structures from which the eggs are formed, is laid even in the prenatal period, that is, even before the woman is born. Not all follicles mature into full-fledged cells that can be fertilized; nevertheless, more than a dozen of them “survive” until the age of 40-50 for the average woman;
- Reproductive organs. Neither the structure of the fallopian tubes nor the muscular membrane of the uterus will change dramatically with age. Only the thickness of the endometrium (inner uterine membrane) can change, but this is corrected during the IVF protocol.
Thus, if IVF is carried out at the age of 40, 9% is an approximate guarantee of having a healthy baby. Do not rush to get upset because of a small number. The fact is that even at the age of 25, the in vitro technique gives only a 48% chance of successful fertilization and embryo engraftment.
Factors that reduce the chance of successful IVF
Modern technologies have advanced so much that medicine knows cases of IVF at 50 years old with its own egg cell, which ended in successful childbirth. However, there are several major factors that significantly reduce the chance of success for older couples. Let's take a closer look.
The presence of inflammatory diseases of the pelvic organs
Hypothermia, any intrauterine interventions, unprotected sex with different partners or one infected person - all these are the reasons for the development of inflammatory diseases of the uterus and its appendages. The body fights the existence of infection by changing the pH, local temperature, and invoking immune cells here.
- existing at the time of IVF, local factors will facilitate the removal of embryos from the uterine cavity;
- often developing before the IVF planning stage, inflammatory processes often lead to the development of adhesions between the reproductive organs. Also, due to frequent changes in pH and attacks of immune cells, the internal structure of the uterine mucosa also changes, which makes it very difficult for embryos to implant into it and receive nutrients from there;
- developing in the ovarian tissue, inflammation leads to a decrease in the follicular reserve.
Abortion and diagnostic curettage in the past
Such manipulations reduce the chance of a positive IVF result at 40 years old, due to the following reasons:
- can cause endocrine disorders that interfere with the normal course of gestation;
- promote the formation of intrauterine adhesions (synechia);
- can cause cervical insufficiency or the development of polyps inside the uterus.
Low follicular reserve
This term means that a woman has few follicles left from which full-fledged eggs can develop, giving rise to pregnancy. With age, the follicular reserve is depleted naturally.
In addition, this condition is aggravated by:
- when the girl initially - due to the difficult course of the mother's pregnancy or her genetic characteristics - got fewer follicles;
- with the transferred inflammatory pathologies of the ovaries;
- endometriosis;
- pelvioperitonitis;
- chronic intoxications - food and industrial;
- due to operations carried out on the appendages;
- when smoking, causing oxygen deficiency of the ovarian tissue.
The presence of a low follicular reserve is indicated by:
- data of a special, transvaginal ultrasound scan - folliculometry;
- low AMH (anti-Müllerian hormone) of the blood, which is produced only by follicles less than 8 mm in diameter;
- high FSH (follicle-stimulating hormone) produced in the pituitary gland. Its increased level indicates that the body is trying to "stimulate" the ovaries to accelerate the development of follicles, but does not receive a response from them.
Partner spermatogenesis pathologies
Most often, women whose husbands are the same age or slightly older want to prepare for IVF after 40 with their eggs.
And age does not affect the reproductive function of men in the best way:
- the level of testosterone decreases;
- long-term exposure to toxic substances, mainly of industrial production (ammonia vapors, pesticides, heavy metals and others), as well as cigarette tar and alcohol, affect the structure of structures responsible for sperm production;
- hypoplasia of the testicles is also caused by the habit of eating foods with an insufficient content of vitamins E, B, C, A;
- prolonged exposure to an electromagnetic field causes changes in the spermogram;
- The permatogenous epithelium also suffers from the effects of infections, which have not always been overt during life and have been treated.
Thus, the older a man is, the more likely his germ cells will be less mobile, agglutinate, or not be able to fertilize an egg.
Severe chronic diseases
Pathologies such as diabetes mellitus, arterial hypertension or heart failure, carried by a woman after 45, make it difficult for her to undergo IVF with her own egg.This is due to the fact that these diseases impair the work of blood vessels, including those that provide nutrition to the reproductive organs.
IVF chances with your egg and donor
Not only does the number of eggs decrease with age; their quality also suffers. As you remember, these structures are laid even before a woman is born, so all negative influences - toxic foods, nicotine, past diseases, poor blood supply - accumulate.
As a result, the eggs lose their ability to fertilize, the risk of chromosomal abnormalities increases, so the embryo may stop developing at a certain stage. That is why IVF after 40 with its own egg is not used for all couples, in 5% of cases an oocyte donor is needed.
Donor eggs are sometimes the only way a woman can get pregnant and bear a baby. For this purpose, an oocyte is taken from a young and healthy woman, whose menstrual cycle will be synchronized with the cycle of the recipient woman using pharmacological preparations.
How to increase the chances of fertilization with IVF
Due to a decrease in the ability of eggs to fertilize, in order to increase the chances of successful conception, couples after 40 are most often used an auxiliary method of fertilization - ICSI (Intracytoplasmic Sperm Injection). In this case, the husband's viable spermatozoon is selected, which under a microscope, with the help of a glass microneedle, is introduced into the egg cell.
If age is combined with low sperm quality, it may be shown:
- ICSI IMSI (Intracytoplasmic Morphologically Normal Sperm Injection): the introduction of a sperm sample into the oocyte, selected under a microscope giving 6000-fold magnification (with ICSI - 400-fold)
- 2) ICSI PIXY, when only such a spermatozoon is injected into the egg cell, which has passed the test for "readiness for fertilization", being dipped in a solution of hyaluronic acid (this substance is contained in the layer surrounding the oocyte). Those spermatozoa that did not die when interacting with hyaluronate have a small chance that they have DNA abnormalities.
Both the latter methods - IMSI and PIXI are also carried out in cases where the previous IVF protocol was unsuccessful or ended in miscarriage, as well as when there is a risk of giving birth to a child with chromosomal abnormalities.
PGD embryo before "replanting"
To exclude chromosomal abnormalities, the chance of which increases with age, preimplantation diagnosis (PGD) is used in IVF programs after 40 years. This is additional testing of a fertilized in vitro oocyte, which has already begun the division process, before it is introduced into the woman's uterus. The same term is used to study an egg even before fertilization, if this woman suffers from a genetic pathology.
For analysis, take 1 cell at the stage when there are from 4 to 10 such blastomere cells (this is the 5th day of embryo development) and they are still absolutely the same. It is examined under a microscope, some laboratory tests are performed (fluorescent hybridization, polymerase chain reaction). If no anomalies are found, embryos are transferred to the uterus on the same or the next day. The terms of the study are extremely compressed, since later the embryo will not be able to continue development outside the mother's body.
Preimplantation diagnosis creates a high probability of having a child without genetic pathologies. It approximately halves the risk of miscarriage and multiple pregnancies, and also adds 10% to the chance of successful embryo implantation.
PGD is possible only within the framework of ICSI and ICSI IMSI. It is performed in a laboratory without any additional effort on the part of the woman or her husband. It can be performed both in couples who have planned IVF after 40 with their own egg, and in those who have used a donor oocyte.
With what IVF attempts it will turn out to get pregnant
Despite the efforts of doctors and women themselves, the number of IVF attempts after 40 years increases, and the percentage of the probability of success the first time drops sharply, which is associated with many processes, most of which take place in the mother's body. The number of repeated IVF attempts is determined by the reproductologist, based on the specific situation.
Thus, it is now quite possible to give birth to a healthy baby with the help of after 40 years with the help of IVF. The technique has been tested on thousands of patients, but depends on a combination of many organismic factors. The success of IVF can be maximally guaranteed only after passing a comprehensive examination and good preparation of both partners.
