Tuesday, 18 January 2022

Am I Too Old for IVF Treatment?

For many hopeful parents that struggle to conceive, in vitro fertilisation (IVF) is a popular solution that allows them to overcome infertility challenges. In many instances, IVF treatment is the most recommended assisted reproduction technology for women looking to have a baby when they are already over the age of 40.

So what happens if you are past the age of 40 years? Or even over 50 years? Can you still undergo the treatment and what is the age limit?

Why Age Matters in IVF Treatment?

Women are considered to be in the advanced reproductive age when they are 37 years and older. As a woman gets older the number and quality of her eggs begin to diminish. This decline becomes steeper once she reaches 35 years.

It is also what makes conception more difficult and is the reason women over the age of 35 years are advised to consult a fertility specialist if they have tried to conceive naturally for at least 6 months without success. Women below the age of 35 years are advised to try for natural conception for at least a year before consulting a specialist. Those over 40 years are advised not to wait at all before seeing their doctor.

The live birth rate in women over the age of 40 years that have received IVF treatment ranges from 4.7-15.7% and drops to just 1-2% for women that are over 44 years old. It is this low success rate that encourages many clinics and their doctors to set an age limit for this treatment.

Men also suffer a decline in the quality and number of sperm as they age. Older men tend to have less semen volume and sperm that has less motility. However, unlike women who go through menopause which is a confirmation that their fertility has come to an end, men may continue to produce new sperm to the end of their lives.

The success rate of IVF treatments where both partners are older does however tend to decline with age. While maternal age is a major factor, paternal age may also contribute to some of the risks associated with pregnancies carried past the age of 35 years. Here we will focus on just the maternal age as most countries do not place limitations on the age of fathers when it comes to IVF treatment.

When it comes to setting limits on IVF treatment, views tend to be diverse. For some experts, this should be a matter discussed and decided between the parents and their doctor. Many also consider the health condition of the woman and her ability to carry the baby to term as being paramount. However, others point to the risks associated with advanced age pregnancies and recommend limits be set to protect the health of patients.

What it comes down to is that even with IVF treatment, chances of success decline the older you are. Therefore, the authorities and clinics may set a limit as it can be a waste of resources to pursue treatment where success is unlikely. No doctor wants to put a patient through such physical, emotional, mental, and financial strain in an endeavour that is unlikely to get them the baby they so desire.

What Are the Age Limits?

As said, opinions on setting an age limit for IVF treatments do vary. Hence where you have ages set, the limit also tends to vary. Based on the National Institute for Clinical Excellence (NICE) guidelines, the NHS in the UK sets a limit for funded IVF treatments at 42 years of age. They do however make decisions on a case by case basis, so the decision may vary. If a patient is declined funding, they may opt for private treatment. With privately funded treatment there is no firm age limit.

In the US, there is no official age limit for IVF treatment. However, most programs will set an age limit of between 42-45 years of age for egg retrieval from the mother. Where donor eggs are used, treatment may be granted to mothers up to the age of 49 years in most clinics. In Canada’s Ontario, women can get public funding for one round of IVF up to the age of 43 years.

In Greece, the government does have oversight on IVF clinics and has set a limit of 50 years for women undergoing treatment. Spain does not have legal limits but their clinics do have ethics committees that have recommended an age limit of 50 years for women. Turkey also does not have a legal age limit but does not permit egg donors. Therefore, IVF treatment is only possible for women that can produce their own viable eggs.

The decision on these limits is dependent on whether there is government oversight and in its absence, the policy of the IVF clinic. These laws and policies can also change with time. So for anyone considering IVF treatment, inquiries would have to be made to establish what the current laws and policies allow.

What to Do?

The first step should be to determine if IVF is the best option for you. You will need to consult with a fertility specialist to establish the reasons you have not been able to conceive. If IVF is prescribed, you need to find out if you qualify. If the IVF clinic you have visited has a good reputation and accepts you as a patient, you can then proceed.

If you have been declined treatment based on age, you may need to look further afield. Going abroad is a possible solution as we have stated that age limits can vary based on where in the world you seek treatment.

Be sure to however consider if you will require the use of donor eggs or sperm. For many women of more advanced maternal age, the key challenge to their getting pregnant lies in producing viable eggs and eventually good-quality embryos. Where this is the problem, the best solution tends to lie in using donor eggs.

Some countries may not have an age limit, but they may place restrictions on the use of donors. They may also not allow IVF treatment if you are not in a heterosexual marriage. Consult with IVF clinics from the country you are considering to determine if they are a good fit for your situation. 

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