Finding Mr Right (or Ms Right) later in life, a high-flying and all-consuming career or realising a baby is a priority after all. These are among the many reasons why women are increasingly turning to motherhood in their 40s, and achieving this through fertility treatment.
More than a fifth of women having IVF in the UK are 40-plus, according to fertility watchdog the Human Fertilisation and Embryology Authority (HFEA). In the last few decades, the proportion of all IVF cycles to patients in this age bracket has more than doubled from 10% (689 cycles) in 1991 to 21% (14,761 cycles) in 2019.
The simple answer is ‘yes’ – and it’s a numbers game. The latest HFEA figures show that a woman aged 40 to 42 has a one in ten (11%) chance of a baby from every embryo transferred compared with 25% for patients aged 35 to 37.
This is because women are born with a finite number of eggs (around 400,00) – one is released every month during the menstrual cycle and thousands are lost naturally. By the time you approach the menopause, the ‘bank’ will be pretty low and the quality of those left will be less than in your 20s or 30s. That means your fertility consultant may need to extract more of them (eggs) in order to create a healthy embryo (and hopefully a baby).
Freezing your eggs in your 40s for use later won’t fix this because the quality will already be poor when you put them ‘on ice’. However, this is distinct from embryo freezing where all developed embryos are frozen then transferred in the next IVF cycle. Studies have shown this technique may actually improve the baby odds.
At the moment, science hasn’t come up with an answer, although testing for quantity is possible. The clinic can also check the developing embryos during the IVF treatment process to see which ones are most likely to implant in your womb.
When IVF fails, it’s often because embryos are abnormal which reduces the chance of having a pregnancy or healthy baby. The eggs and resulting embryos of older patients are more likely to be affected in this way, e.g. with extra or missing chromosomes.
This is where a special technique called preimplantation genetic testing for aneuploidy (PGT-A) could help if you’re the other side of 40. It may sound a bit scary but how it works is fertility specialists – the embryology team – take a tiny number of cells from the embryo and test them. An important consideration with PGT-A is that you need enough embryos to choose from. If there’s only one, then there’s not much value in using this approach, and as yet, there’s no conclusive evidence that PGT-A increases the chance of a live birth.
Of course, you may be reading this thinking how did all those smiling 40-something celebrities posing with cherubic newborns on Instagram manage it? In reality, many will have created their family, not with their own eggs but those donated by another woman. Opting for IVF using donor eggs may be a consideration if yours are failing to fertilise or the clinic cannot collect enough from you.
Another look at the HFEA data shows this increasingly popular approach could treble your chances of becoming a mother, with a 33% birth rate per embryo transferred among women in their early 40s (age 40 to 42) who used egg donation. For those in their mid to late 40s (45 to 50) the rate is significantly increased compared with using their own eggs (31% vs 4%).
Don’t forget that diet and lifestyle play a significant role also in realising your dream of parenthood, especially when embarking on your IVF journey in your 40s. Taking care of your mind and your body through good nutrition and moderate exercise is key. Top tips for improving your baby chances include maintain a healthy weight, keep alcohol to a minimum or cut out altogether, and stock up on vitamins and minerals, especially folic acid and vitamin D.
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