The use of in vitro fertilization (IVF) to become pregnant is on the rise in the United States, especially among women over age 40.
It may seem that IVF is the fix for age-related fertility decline, but that’s a false and potentially harmful assumption, Nichole Wyndham, Dr. Paula Gabriela Marin Figueira, and Dr. Pasquale Patrizio write in Fertility and Sterility, a journal published by American Society for Reproductive Medicine.
The truth is, a woman’s age has a huge effect on how likely she is to have a baby through IVF, as well as via the old-fashioned way. Yet a look at the growth of IVF among older mothers suggests that this fact might be unknown or simply ignored, with optimism winning out over data.
The number of IVF cycles done for women of all ages using their own, non-frozen eggs increased by 5% from 2003 to 2013, according to data from the Society for Assisted Reproductive Technology (SART), the professional organisation for fertility clinics.
In that time, the number of cycles done for women older than 35 increased even more — by 7%, mostly driven by increases of 18% for women age 41-42 and an astonishing 79% for women older than 42. (In raw numbers, IVF is still much more common among women in their 30s.)
Such increases are dramatic, but given that the average age of a first-time American mother has reached a record high, while women’s fertility declines with age the same as it always has, it’s not too surprising more women are turning to IVF.
IVF is a procedure in which eggs are taken from a woman’s ovaries and fertilised with sperm in a petri dish. Then one or more fertilised embryos are placed in the woman’s uterus, where one will hopefully implant and grow into a baby.
Perhaps surprisingly, the surge in the popularity of IVF — especially among older women — is not an indication of how well it’s working. In 2013, data from the Society for Assisted Reproductive Technology shows only 4.5% of IVF cycles in women over age 42 resulted in healthy babies, exactly the same percentage as in 2003. Meanwhile, 40.1% of cycles in women under age 35 in 2013 resulted in births.
Those numbers suggest that the women who are least likely to see success with IVF are the very same group using it more and more.
As a woman ages, her eggs age too. Older eggs are more likely to have an abnormal number of chromosomes, which will prevent them from developing into healthy babies if fertilised. Women who try to get pregnant when they’re older are thus at a greater risk for miscarriages.
Besides that, older women are more likely to face complications to pregnancy like gestational diabetes, and are more likely to give birth prematurely, the researchers point out in Fertility and Sterility. IVF doesn’t address these increased risks and difficulties for older women trying to become mothers.
There are a lot of reasons involved in a woman’s decision to delay having kids, such as wanting to reach educational or professional goals, or wanting to be financially solvent as well as in a stable relationship, the researchers note. But a more “troublesome” factor is when women don’t realise they’re setting themselves up for greater risks by putting off having kids, the researchers say.
“Women appear to be unaware of the varying success rates, or of the risks associated with fertility treatment, such as multiple pregnancies,” concludes a review paper cited by the researchers.
In the worst-case scenario, women who put off having kids in hopes IVF will ensure they’re able to conceive past their peak fertile years could face “irreversible future infertility and disillusionment,” the researchers write.
While scientists are developing technologies that might one day make it less of a long shot for older women to have kids through IVF, in its current state the procedure is definitely not a magic tool to turn back the biological clock.
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