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Recent research indicates that older women experience reduced success rates with fertility treatments, even when utilizing donor eggs from younger women. Specifically, there is a noticeable decline in effectiveness starting around age 49. These findings, based on a study involving 1,774 women, challenge the common belief that using donor eggs completely “resets” a woman’s reproductive timeline, although experts advise that older couples should not be discouraged from attempting fertility treatments.
The study revealed that women aged 49 and above had twice the risk of miscarriage compared to those between 35 and 40 years old, and they were also less likely to achieve pregnancy. The research team suspects that age-related changes in the uterine lining, or endometrium — the site where a fertilized egg implants and develops — could be responsible for these outcomes. Although the thickness of the endometrium remained consistent across age groups, its overall condition appeared to deteriorate with age, potentially influencing fertility. Researchers suggest that future treatments might focus on predicting, preventing, or improving the condition of the uterine lining to increase the likelihood of successful pregnancies.
Dr Beatrice Crestani, the lead investigator from an assisted reproduction medical institute in Italy, notes that reproductive aging has traditionally been viewed as an ovarian problem. “The idea has been that if you replace older eggs with younger donor ones, you ‘reset’ the reproductive clock,” she explains. However, she emphasizes that the study’s results reveal a more complex picture. For example, women in their mid-to-late 30s who underwent IVF with donor eggs had a 54% chance of achieving pregnancy, whereas this rate dropped to about 43% in women aged 49 and older. Additionally, live birth rates decreased from 46% to 32%, and miscarriage rates rose from 24% to 38% as age increased. Dr. Crestani advises that these findings should not discourage women from pursuing donor egg treatments, since success rates remain significant, but cautions that donor eggs do not entirely offset the effects of reproductive aging, particularly after age 49. Among women who transferred all available embryos, the live birth rate was approximately 80% for those aged 35-40 and 62.5% for those 49 or older.
Sharing a personal perspective, TV soap expert Sharon Marshall recounted her arduous journey with IVF during her 40s, culminating in the birth of her daughter Betsey at age 46 after six years and multiple attempts. “We look at celebrities who have given birth in their late 40s, early 50s and beyond. We celebrate them. We don’t know what hell they’ve been through,” she reflects. Marshall spoke openly about the emotional toll, describing her experience as a prolonged period of illness and depression with a profound loss of control over her body. Despite suffering two miscarriages before finally conceiving on her seventh IVF cycle, she says, “I never once felt calm… until the point she was born.” Commenting on the study, she emphasized the importance of honest conversations, stating, “Let’s be honest with women about the difficulties they may face, about how hard it can be to get pregnant when you get older. We deserve to know that.”
Experts also highlight that the health of a woman’s womb and ovaries varies individually. Unlike some European countries such as Greece, which limits IVF treatment to women under 54, the UK does not have a legal upper age limit for IVF. Women up to age 36 can donate or share eggs in the UK, and private clinics are required to assess the welfare of the child and the physical capability of the recipient to safely carry a pregnancy. NHS guidelines recommend offering up to three cycles of IVF to women under 40 and one cycle for women up to age 42. Those utilizing donor eggs often have to cover the costs themselves. Additionally, children conceived with donated gametes or embryos from registered donors after April 1, 2005, have the right to request identifying information about their biological donor once they reach 18. The study’s findings were presented at the European Society of Human Reproduction and Embryology (ESHRE) and published in a medical journal. Prof Borut Kovacic, Chair-elect of ESHRE, highlighted the significance of understanding communication between the embryo and the womb lining. He noted the identification of an age threshold marking the onset of uterine aging, while cautioning it is unlikely to be an absolute boundary. Dr Ippokratis Sarris, chair-elect of the British Fertility Society, called for further research and advised that thorough health screening and counselling should be mandatory for older couples undergoing fertility treatments due to heightened pregnancy risks
Read the full article from The BBC here: Read More
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