ЭКО после 40 лет

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Natural pregnancy after 40 years

A woman's fertility is highest between the ages of 18 and 29, when most of the menstrual cycles are ovulatory. That is, almost every month the ovum ripens in the ovaries and, when favorable conditions are created, conception is possible. With age, the number of ovulatory cycles decreases significantly, and the chances of getting pregnant fall.

Unfortunately, the probability of a natural pregnancy is not too high. By the age of 40, it does not exceed 10-15%. At 50, the odds are close to zero. Although world history knows many cases when women became pregnant and gave birth to children at 50, and even at 60, these are only exceptions to the rules. For an average woman, conceiving after 40 years without resorting to medical care is almost impossible.

In addition, with age, the risk of developing chromosomal abnormalities, various birth defects, for example, Down syndrome, cerebral palsy. According to world studies, if women aged twenty-nine years of age and older have birth defects in approximately 4-6% of cases, then after forty, they appear in 9%.

What to do, how to deal with this problem? In such cases, modern ART will come to the rescue. In particular, good reviews of IVF at this age indicate that it is quite possible to achieve pregnancy in this way.

Factors Affecting Pregnancy

Unfortunately, in addition to decreasing the number of ovulatory cycles with age, health problems may arise that affect, if not conception, then pregnancy. That is why doctors recommend not delaying the birth of a child. But if this still happened, first you need to find out whether a woman can become pregnant and bear a baby.

The possibility of a natural pregnancy depends on many factors:

• the presence or absence of somatic, endocrine and infectious pathologies;
• individual characteristics of the woman's body;
• the rate of development of involute processes leading to the extinction of the functional activity of the reproductive system.

Diagnostic tests performed at AltraVita Clinic include:

• Hormone tests. Laboratory determination of the level of sex hormones is performed on different days of the cycle, the ovarian reserve of the ovaries is determined.
• Instrumental research. Hysteroscopy, colposcopy, hysterosalpingography, ultrasound of the pelvic organs and other studies allow us to assess the condition of the reproductive organs. With age, the likelihood of developing gynecological diseases increases. Many of them negatively affect fertility.
• Assessment of somatic health. A woman needs to pass a coagulogram, blood for sugar and thyroid hormones, ECG, fluorography, ultrasound of the mammary glands and some other studies.

They allow you to determine if there are any contraindications to pregnancy. Then begins preparation for the in vitro fertilization protocol.

In preparation for IVF after 40 in clinic "AltraVita" may be assigned such examinations as:

• analyzes of smears from the urethra and vagina for genital infections;
• blood tests for especially dangerous infections;
• cytology of a smear from the cervix;
• clinical blood and urine tests;
• blood chemistry;
• examination of doctors of various specialties.

If necessary, the study of a man to diagnose the possible presence of infertility in him is included in the diagnostic process and determining the possibility of a woman becoming pregnant. At a minimum, the spouse must pass a spermogram. Based on its results, the issue of conducting additional diagnostic measures are considering.

The condition of the ejaculate is also important for choosing a program. So, in case of impaired sperm motility, the appearance of pathological forms in the sperm, it may be necessary to conduct morphological selection of the sperm and intracytoplasmic injection (ICSI).

If criteria are found that sharply reduce the possibility of conceiving a baby and the normal course of pregnancy in a woman, the center’s doctors can recommend an IVF program after 40 years.

Natural conception is a matter of chance, which often depends on many factors. Even if you accurately determine the day of ovulation and create all the necessary conditions for fertilization, conception may not occur.

During the IVF protocol, stimulation of ovulation allows you to take several eggs. And if some of them do not fertilize, it remains an opportunity to get a full-fledged embryo for transfer to the uterus.

Another problem for those who decide to become pregnant after 40 years old is the risk of having a sick baby. The likelihood of a newborn having Down syndrome and other pathologies at this age increases sharply. In vitro fertilization, it is possible to select high-quality embryos using PGD.

Which not only reduces such risks, but the woman does not lose valuable time, because with age new problems and diseases may appear. And an extra psychological trauma due to failure can also affect a woman's condition.

According to the studies of scientists from the University of Adelaide, who analyzed more than 300 thousand natural births and 3600 in vitro fertilization procedures in age-related patients, interesting data were obtained. It turns out that birth defects in "test-tube babies" appear much less frequently in 3.6% of cases than in naturally conceived children at this age. This figure is even less than that of women in labor over 29 years of age. That is, after forty IVF is not only effective, but also reduces the risk of developing abnormalities in the fetus.

It has been suggested that the drugs used in the protocol have a positive effect. Although an important role is played by the careful selection of planted embryos.

IVF options for women over 40

After a comprehensive study, the doctor can determine one of several options for the data of ART and IVF after 40 years:

• Artificial insemination with the sperm of a husband or donor.
• IVF in a stimulated cycle. Usually a short protocol is used. An important condition is the presence of a sufficient ovarian reserve.
• IVF in the natural cycle or with minimal stimulation (with reduced ovarian reserve).
• IVF with donor oocytes - if receiving your own high-quality germ cells seems unlikely.

Sperm injection into the cytoplasm of the egg (ICSI), followed by implantation of the embryo on the mucous membrane of the woman’s uterus. It is quite common and in many cases allows a successful IVF after 40 with its own egg.

Comprehensive diagnosis data suggest not only an assessment of the fertility of the couple, but also the absence of contraindications to the procedure and pregnancy. The main ones: mental abnormalities, somatic diseases that prevent bearing, genital gland pathology, deformations and abnormalities in the structure of the uterus, a cancerous tumor of any localization. A relative limitation is inflammation and benign masses in the genitals.

The specialists of our clinic try to carry out in vitro fertilization with their own egg, even at the age of 45, if possible. Usually a natural cycle is used with minimal stimulation, which allows to minimize the adverse effect of hormonal drugs on the body.

But problems with age arise not only in women, but also in men. In such cases, IVF with ICSI is used. In the AltraVita clinic, to determine the effectiveness of the protocol and reduce the risk of developing chromosomal abnormalities in the fetus, a technique for determining the spindle is used. Thanks to special equipment, it is possible to visualize the spindle elements and conduct ICSI without risking damage to it.

After successful fertilization, preimplantation genetic diagnosis is prescribed in age-related patients. It eliminates mutations and congenital malformations during IVF after 40, the risk of which increases with the age of the expectant mother. PGD is carried out before the implantation procedure and consists of a biopsy of the embryonic cells at the stage of zygote division (fertilized egg cell). A single blastomere is usually taken for research. The main advantage of this diagnosis is that there is no need for an abortion and high chances of having a healthy baby without genetic abnormalities.

If it is not possible to get a quality egg from the mother, we suggest using a donated egg for fertilization. The results of studies show that the use of donor material in women aged gives very good results. If the usual protocol is successful in 26-30% of cases, this indicator is lower than in young patients, then in IVF with a donor egg, pregnancy occurs in 49% of cases.

It is still not well understood why this type of program gives such high results, but studies by scientists from different countries confirm this, as well as the long-term statistics of our clinic.

That is why our experts advise not to waste time on new attempts, but to use donor material in such cases:

• if an age patient has difficulty receiving an egg;
• during the embryological stage, it is not possible to obtain a high-quality embryo.

Altravita Clinic has its own cryobank and a large donor base, from which you can choose the most suitable candidate. Our experts will provide all the necessary information about the donor (eye, hair color, constitution, nationality, education, etc.).

We also have a surrogate mother database, if during the examination it turns out that pregnancy is contraindicated for a woman. All candidates are thoroughly examined, have their own healthy children.

Thanks to the use of the latest approaches in the treatment of infertility and ART, doctors at AltraVita clinic often manage to get positive IVF results after 40 years. Contact our center. With a high probability this will allow you to become pregnant even at a late reproductive age.