Please note this represents a typical story and is not directly related to any one patient and therefore to any of the given testimonials from our patients. It does represent many elements of dealing with infertility, medical and psychosocial that are a constant in this group of patients
This story illustrates many of the issues that mature aged couples may have to face including:
• Unrealistic expectations based on media hype and maybe not realizing the limitations of Assisted Reproductive technologies when it comes to using their own eggs and sperm
• Diminished ovarian reserve (DOA) results in fewer eggs for retrieval. Although this is more commonly seen in older women DOA occasionally is seen in younger women presenting with infertility and may indicate imminent premature menopause
• In addition to a reduced number, egg quality can be reduced, leading to the possibility of reduced fertilization and cleavage rates and hence embryo quality
• The increase in miscarriage rate due to genetic abnormalities which results from longer exposure of “resting” M1 oocytes (eggs)
• As with all patients financial and emotional reserves can be even greater for older women as often more cycles may be required to achieve a pregnancy
• Perhaps one of the most important observations, however, that counters the above is the individual persistence and enduring human spirit of patients that can contribute in some unfathomable way to positive outcomes.
Sally and Don's journey:
I married later in life, having not been fortunate enough to have met the right person earlier. Neither my husband or I had any previous children or pregnancies from previous relationships. We had reached a point in our lives where parenthood was more than just appealing but in view of my age was it possible? I was 42 years old and my husband 48 years. Well I had seen in the popular media countless stories of celebrities, much older than I, having children no problem! This was encouraging until I was advised that in many cases these were the result of donor eggs, maybe donor sperm and maybe even surrogacy. In other words someone else carried the pregnancy. I was just entering the rabbit hole.
To make matters worse we also discovered we had a male factor component to our infertility requiring another procedure (ICSI) in addition to IVF. After 4 failed IVF cycles I was deeper down the ‘rabbit hole’ depressed, self-esteem gone. Having a baby was something I thought I really wanted but now it is something I felt I couldn’t live without- a mounting preoccupation/obsession/depression I was told was common to women having to go through repeated cycles.
To cut a very long painful story short, two more cycles resulted in cycles with a better response giving renewed hope! The very last one resulted in success!! 7 weeks later a confirmed fetal heart beat, early genetic screening all clear and many more weeks later a healthy baby-a true miracle.
I knew if it hadn’t worked out for us, as happens to some people, we would have been ok and eventually moved on knowing we had given it our best shot.
It is now, however, impossible to imagine our lives without this new little person. Gratitude for the small things along the way helped, persistence and trust got us through it.
Advanced Maternal Age
The woman’s age by far is the most important factor in the absence of any other underlying causes. At birth there are approximately two million eggs. By the time a woman reaches puberty only about 600,000 remain. And by age 37 there are about 25,000 eggs. So by the age of menopause there are very few eggs available.
As there is a very rapid decline in fertility from 35 onwards it is important for a woman to see the family doctor earlier and be referred to a fertility specialist promptly. Being properly assessed at an earlier stage allows for a better chance of natural conception, which is variable but averages 20 per cent per menstrual cycle.
By age 40 the probability of conceiving naturally drops to less than 10 percent per menstrual cycle and may drop to even less than five percent. For more information on your chance of achieving a pregnancy and to identify and correct any potential underlying causes you should see your family doctor early so that you can be properly assessed and, if necessary, be referred to a fertility specialist.
Source: Dr. Anthony Cheung, Grace Fertility Centre http://www.healthchoicesfirst.com/category/fertility/female-fertility/what-factors-influence-female-fertility