Infertility treatment options for women over 40

As a woman ages, her reproductive capacity decreases. While the likelihood of naturally occurring pregnancy is about 20-25% per month for a woman in her twenties and thirties, that possibility has decreased to 5% for a woman in her early forties. The decline in fertility is noted most acutely in IVF therapy. In fact, age is the most important factor in IVF success rates. For women under 35, each fertilized embryo has about a 30% chance of implanting in the uterus. By the age of 43, that possibility has dropped to less than 5% per embryo. (Since generally more than one embryo is transferred per IVF cycle, the actual success rate can be higher than this. Click here for more details.) The poorer IVF outcome is caused by the declining quality of the woman's eggs. And while nothing can be done to improve the quality of the eggs, there are techniques which can be used to compensate, and thus improve IVF outcome: Higher doses of ovulation induction medications, carefully monitored on a daily basis, can increase the number of eggs available for aspiration. With more eggs, a greater number of embryos can be implanted, and the odds of pregnancy therefore increased. Assisted Hatching involves microscopically removing part of the casing around the embryo just prior to transferring it to the uterus. This gives the embryo a better chance of "hatching" and attaching to the uterine lining. For women whose ovaries are no longer producing good oocytes (eggs), oocytes from a relative or anonymous egg donor can be used. Reproductive age does not always match a woman's chronological age, however. Thus, two blood tests - FSH (follicle stimulating hormone) and E-2 (estradiol) - can performed on the third day of the menstrual cycle to determine whether a woman is still producing eggs and is still fertile. While these tests cannot be relied on as absolute (and should not, therefore, be utilized by a woman who does not want to become pregnant to determine that birth control should be discontinued), they are used by fertility specialists to judge whether a woman is a good candidate for IVF or other fertility therapies.