How old is too old to do IVF?
When a patient over 39 consults a fertility clinic because she isn’t getting pregnant, as fertility doctors we find ourselves explaining once again how low human fertility really is.
At the Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Lisbon last week, Dr. Marta Devesa from the Dexeus Institute in Barcelona presented her data on a 12 year study that shows that cumulative live birth rates following IVF declines by 23.6% in women aged 38-39 years to 1.3% in those aged 44 and over. This is certainly not the first study which shows such a rapid decline. It is important to note that these IVF cycles are performed with the patient using her own eggs. However this fast decline is not visible in egg donation cycles. According to Dr. Devesa’s studies, live birth rates still have the same high success rate when using egg donation (between 60-70%) in higher aged women. Apparently it is the age of the egg, which is most times synonymous with egg quality, that’s important, not the age of the uterus.
This study looked at the women undergoing IVF using their own eggs in 4 different age groups: 38-39 years, 40-41 years, 42-43 years, and 44 and over. The results are not surprising: the live birth rate decreases as age increases. The cumulative live birth rates were 23.6% in the first age group, 15.6% in the second, 6.6% in the third, and in the fourth group of women aged 44 and over, it was only successful 1.3% of the time. These statistics are derived from 5,841 IVF cycles completed over a period of 12 years. It was also found that there is a higher probability of having a baby in the fresh cycle if the patient freezes embryos. It seems that the greater the ovarian reserve, the higher the probability of getting pregnant in their fresh cycle. On the contrary, this is not the case for the frozen cycle, where cumulative birth rate is still extremely low.
This is the largest study that has been published analyzing the data of patients over 38 using their own eggs so thoroughly. This predictive model is the proof of what we as fertility specialists see in our daily practice: the probability of getting pregnant in a fertility clinic over 42 and using one’s own eggs is low. When we often try to explain these demonstrated facts to our patients, they strongly believe that as a women aged 44 with a 1.3% probability of getting pregnant, that they will fall into that minimal percentage of 1.3. This is why we allow them go through an IVF cycle with their own eggs at older ages. When they see that they usually do not even get to the stage of egg retrieval, they either move to egg donation or stop fertility treatments completely.
As a woman ages, so do her eggs. This implies that the eggs have more and more anomalies as the years go by, and it becomes more and more difficult for a woman to have a normal baby. Dr. Devesa’s study will be a helpful tool for fertility experts when trying to explain to patients their possibility of pregnancy according to age.
At ProcreaTec, we recently looked at the age of our patients who received donor eggs that had undergone cycles in 2013. The percentage of women who got pregnant under age 45 was 65.08%. Women aged over 45 had a 66.66% success rate at getting pregnant. This concurs with what Dr. Devesa reported at the ESHRE conference.