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Fertility at forty – or even thirty

by Dr Gillian Lockwood
continued from page 2
In-Vitro fertilisation

Many women in their late thirties or early forties choose to have IVF treatment even if there is no apparent explanation for their failure to conceive other than their age. IVF is recognised to be an effective (and diagnostic) treatment for this so-called ‘unexplained’ infertility. Women in this age range are also acutely aware that their biological clocks are running down very fast and they cannot risk waiting (or wasting!) another 6 months to ‘give Mother Nature another chance’ since success rates of fertility treatments such as IVF depend on the age of the woman concerned.

For more information see other related articles:
The cost of IVF
IVF - what you need to know.

The success rates for IVF (approximately 25% per cycle for women under 40 and 15% per cycle for 40+) depend upon a woman having good ‘ovarian reserve’, that is being able to recruit a good number of ovarian follicles in response to the stimulating drugs used in IVF. Assessing ovarian reserve is therefore a very important part of counselling a couple about their individual chances of success with ‘high-tech’ fertility treatments such as IVF. Age, past medical history, FSH (follicle stimulating hormone) levels and ovarian scan results all provide useful information for predicting the likely chance of success with treatments such as IVF. In addition, some fertility specialists are now advising women to have their inhibin B level assessed. This simple blood test, (taken during day 3-6 of the menstrual cycle), provides a direct measurement of ovarian reserve.

The future

It is now possible to freeze human eggs and then thaw them and use them to generate embryos for transfer in an IVF cycle. At the moment this technology is mainly used to help young women who are facing a diagnosis of cancer. Lifesaving chemotherapy or radiotherapy will probably render them sterile and the technique of egg freezing allows them to ‘bank’ their oocytes (eggs) for later use, so that they have a chance of giving birth to their own genetic children.

This same technology could be applied to allow young women who were not yet in a position to become pregnant to store their eggs for use later when they wished to start a family. Clearly this new approach to ‘family planning’ may meet with some resistance. For future generations though, it could offer a solution to the ‘career women’s’ dilemma about when to start a family.

For more information look at Infertility treatments what the future holds.



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