Women Over 35

The chances of having a healthy baby are based on various factors with age playing a major role. As a woman’s reserve of good quality eggs begins to diminish from the age of 35 years, many women planning a family late in life face infertility problems. Assisted reproduction is a series of procedures that allows couples struggling with genetic or fertility issues to be able to have a child. Treatment usually starts by stimulating the release of an egg (controlled ovarian hyper stimulation or COH) and introducing healthy sperm directly into the uterus to help in fertilisation (intrauterine insemination or IUI). If these methods fail, hormonal therapy and IUI may be indicated. This is a long and tedious process that involves many cycles and is associated with a lot of stress before a woman can actually get pregnant and give birth. For women over 35, these procedures usually have low success rates. A recent study has suggested that women over 35 stand a better chance of conceiving with fewer attempts and lesser stress if they forego the other procedures and go straight to in vitro fertilisation.

In vitro fertilisation (IVF) involves fertilising the egg and sperm in the laboratory. Besides, saving a lot of time and money, it improves your chances of having a healthy baby, a factor that is dependent on your age.

In vitro fertilisation involves multiple steps:

  • Collecting eggs and sperm: You will be given medication to produce multiple eggs, help the eggs mature, time the release of eggs from the ovary and prepare your uterus for implantation. When the eggs are released, they are usually retrieved with a probe inserted into your vagina under ultrasound imaging. Around this time, your partner will be asked to provide a sperm sample. Surgical procedures may be used to retrieve eggs or sperm if necessary.
  • Fertilisation: The eggs are fertilised by mixing them with sperm or introducing sperm directly into the eggs with instruments. Other maturation and testing procedures may be recommended before implanting the egg in your uterus.
  • Implantation: The fertilised egg or embryo is then transferred into your uterus with a thin flexible tube during an office procedure to implant itself into the lining of the uterus.

Following the procedure, you are advised to avoid strenuous activity to prevent discomfort. You may experience some fluid or bloody discharge after the procedure which is normal. Other side effects include constipation, bloating or cramping. Although IVF is the most successful reproductive technology available, you may have to go through a few cycles before conceiving.

Summary

  • While 35 is the age at which many females experience a significant drop in fertility it is not the actual number in years that is important but rather that all women experience a progressive drop in fertility with advancing age Today this is one of the most important causes of infertility.

  • Technology such as IVF cannot overcome the problem of advancing female age and so education and not deferring conception are the 2 mainstays of management.

  • In addition when older females do wish to conceive it is essential to exclude any other fertility problems and ensure correct timing of ovulation to maximise each monthly attempt. The take home message is check your fertility situation out as soon as possible.

For more information on the subject of age see my "FAEQ's" (Frequently Asked Egg Questions)