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Forum Name: Gynecology

Question: fertility in older women


 artemis99 - Fri Nov 13, 2009 12:57 pm

my fiance and i would like to conceive a child through in vitro methods or another method that allows the women to carry the fetus to term. I am 55 years old and post
menopausal and he is 44 years old, how feasable is this and what would it take as far as preparation before therapy or treatments.
 Debbie Miller, RN - Mon Jan 04, 2010 10:40 pm

User avatar Hello,
When you read in the tabloids about women in their 50s giving birth, they usually fail to mention that donor eggs and possibly sperm are used. This is the protocol because females have all the eggs they will ever have when they are born and as we age, these eggs get older and there is a higher incidence of abnormalities associated with children conceived with these older eggs. For this reason, donor eggs are almost always used in these IVF attempts. Often donor sperm is also used since there are higher risks of defects when using aging sperm, though it is less often associated.

The record age for spontaneous pregnancy in modern times is 57 years. There are older women who gave birth with assisted reproductive technologies.

Aside from the risk of birth defects in older eggs, there are more maternal risks in older moms such as gestation diabetes, hypertension, miscarriage, pre-eclampsia, ceasarean birth, and placenta previa. The babies are at greater risk of premature birth, low birth weight and SGA (small for gestational age).

If you are in good health, understand the health risks and relatively low success rate and you definitely want to pursue this option you should consult with a fertility clinic. Each clinic can set their own guidelines regarding age and health of the women (in the U.S.) they consider to be good candidates for the procedure.

Hormones are typically used to prepare the uterus. The first step is to suppress the pituitary gland. This is necessary to reduce the chance of ovulation occurring unexpectedly. Lupron is most often used for pituitary suppression. For most women, this will require approximately two weeks of daily Lupron injections.

Then hormones are used to duplicate the changes that normally occur in the uterus during a regular menstrual cycle. This requires the use of estrogen and progesterone. The fertility experts you choose will have a protocol of preparation.

In addition, you should do all you can to be in good health, emotionally as well as physically. This would include eating a healthy diet, avoiding any bad behaviors such as use of alcohol, tobacco and drugs, assure that you are at a healthy weight and any underlying physical problems are addressed, including sexually transmitted infections. You should have a preconception visit with your gynecologist to be sure everything is as healthy as possible to help insure success. I would even recommend psychotherapy if possible to be sure you are emotionally prepared and healthy. You are considering a very serious life decision and most of us can benefit from this kind of counseling. Of course financial concerns are also a matter of concern. Assisted reproductive technology is very expensive and it can fail sevral times before you succeed, if in fact you are successful at all.

I would also consider a backup plan such as an overseas or local adoption in case you do not succeed but really want to have this experience of parenting with your husband. Some agencies do not place children with older parents but some do.

Good luck on this journey.

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