Meeting or beating the age barrier of infertility

Aging oocytes, advanced maternal age, diminished ovarian reserve…by any other name, these are the ‘labels’ that many women over 35 may hear when they’re not expecting and trying to figure out why.

Yet, in the face of Father Time, it seems as though nothing can be done, particularly when it comes to biology.

I know these discussions all too well. Many women come to us in peak physical condition, looking 10 years younger than they really are. But, your ovaries don’t care. They are programmed by their own clock, one that tends to favor the younger egg.  By the age of 40, a woman’s egg supply is approximately 3 percent of the million eggs she was born with.

Yet, despite what may seem like somber odds, there are methods for beating the clock:

1) Preimplantation Genetic Screening (PGS) – An option when doing Invitro Fertilization (IVF) is to utilize PGS as a means for determining each embryo’s chromosomal ‘health.’ It’s not just the number of eggs that decrease as a woman ages, but the quality of those eggs, as well. By the early 40s, as many as 70-90 percent of eggs will have a chromosomal abnormality which can result in a variety of genetic conditions including Down Syndrome.  Chromosomal abnormalities can also result in an embryo that does not implant or is miscarried.

By utilizing PGS and only selecting the healthy embryos to transfer, the chance of a pregnancy, as well as a chromosomally normal pregnancy, are greatly increased, allowing for parity of outcomes, even when comparing women of different ages.

And since chromosomal abnormalities exist in women of every age (despite increasing over time), PGS can also help balance the odds for any woman to conceive and carry a healthy pregnancy.

2) Egg Freezing

Approved by the American Society of Reproductive Medicine (ASRM) as a non-experimental means of preserving fertility, egg freezing can help women past their reproductive ‘prime’ to conceive. Provided that eggs are frozen at a younger age (<35), egg freezing can offer an ‘insurance policy’ to women whose life circumstances, health etc. prevent them from conceiving a child during their ‘peak reproductive years.’ By no means should Egg Freezing be used as a reason to put off having children. Oftentimes, however, professional, personal or medical reasons make this scenario difficult to impossible. Egg freezing then provides another opportunity to ‘level the playing field’ in later years, allowing a 40-something woman to conceive when eggs that were frozen in her 20s or 30s.

3) Donor Egg

When a woman feels as though she has exhausted her resources (medically, financially or emotionally) to conceive with her own eggs due to age, medical/congenital issues etc., donor eggs provide an opportunity to carry and deliver a child. Studies have shown that even if a woman is perimenopausal or in menopause, she can successfully conceive and carry using an embryo created from donor eggs.

4) The rule of 3s

If a healthy woman, regardless of age, has conceived, and made it out of the first trimester, her odds of the pregnancy resulting in a live birth are almost the same, regardless of age. And the chances to have a good outcome and a healthy baby are very high.  Of course, we still recommend all the routing testing during prenatal care.

Human reproduction is an inefficient process at best, regardless of age. But for those who are entering the process later in the game, it’s good to know that there are options.

Dr. Elena Trukhacheva, MSCI, is one of the field’s devoted female reproductive endocrinologists, who demonstrates a unique rapport and understanding of her patients. As a woman and a mother, she takes pride in providing comprehensive care and strives to bring hope and support to her patients. Dr. Trukhacheva is Board Certified in the specialty of obstetrics and gynecology and in the sub-specialty of reproductive endocrinology and infertility.