IVF After 40: How Fertility Options Change With Age

by | Jul 23, 2018 | Expert Stories | 0 comments

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You’ve finally finished that degree, perhaps started a company, or maybe you just feel like it’s the right time. Regardless of the reason, two things are certain: you’re 40 years old and you want to become a parent.

According to the Centers for Disease Control and Prevention, birth rates among women aged 40-44 are higher than ever before, jumping 2 percent from 2016. But, if you’re considering postponing parenthood or pursuing in-vitro fertilization (IVF) after 40, it’s important to keep in mind how fertility options and their success rates change with age.

IVF and Women Over 40

For women, age becomes a factor around 35, says Gena Shepard, MS, CGC, a board-certified clinical genetic counselor at Oregon Reproductive Medicine. “40% of embryos have abnormal chromosome results,” she continues. “And by age 40, this number jumps to 65%.”

Women seeking in-vitro fertilization after 40 not only have fewer viable embryos because of chromosomal abnormalities, but they also produce fewer eggs. This means that after all the embryos are tested through comprehensive chromosome screening (CSS), only about 35 percent have a chance of producing a healthy, successful pregnancy — a crucial difference between younger women and those undergoing IVF after 40.

Consequently, parents-to-be who are carriers of a known genetic disorder may encounter additional challenges when pairing IVF with preimplantation genetic testing (PGT), says Shepard. Performing PGT for aneuploidy and PGT for single gene disorders means each embryo has to pass two tests, she explains. “It’s much more difficult to find an embryo with normal chromosomes that’s also not affected by the genetic disease.”

If you’re older than 43 and want to do PGT, Shepard recommends considering an egg donor. “Typically it’s the most successful and cost-effective option,” she says.

Effects of Advanced Paternal Age

Women aren’t the only ones listening to their biological clocks. Male reproduction — once assumed to be untouched by age — might have an end date as well, according to a paper published in PLoS One. There may be an increased risk to the offspring with advanced paternal age starting at around 40-45, says Shepard. However, there’s no current consensus. “While the risk is low during 40, a man in his 50s looking to conceive might want to consult a fertility specialist,” she adds.

Discussing the risks with your fertility doctor or genetic counselor might be more important than you think. Research has linked achondroplasia— a form of dwarfism — along with autism and schizophrenia to advanced paternal age, says Shepard.

While men can have their sperm analyzed to determine count and mobility, “There aren’t any genetic tests that can screen for autism or schizophrenia,” Shepard explains.

Know Your Options

Whether you’re deciding to postpone parenthood, or you’re ready to conceive later in life, knowing how fertility options change with age and engaging with a specialist will provide all the necessary information for making an informed decision as you plan for the future.

Dawn Michelle Lipscomb, PhD, is a biophysicist, podcast host, and science writer. While finishing a dual B.S. in Physics and Biology at UT San Antonio, she published research on planetary biosignatures for space exploration at NASA-JPL and designed THz bioeffects experiments for human tissues at the Air Force Research Laboratory. In 2017, she completed her Biophysics doctorate at UC Berkeley by developing a new method for imaging proteins that regulate gene expression using cryo-electron microscopy. Today, she co-hosts a live video podcast series on regenerative medicine and writes articles about groundbreaking research in aging and genetics.

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