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Ask the Doctor: Can in vitro fertilization solve the problem of age-related infertility?


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Ask the Doctor: Can in vitro fertilization solve the problem of age-related infertility?

You asked: If a woman has difficulty getting pregnant due to age, can’t she just use IVF?

Dr. Klein says:

Many women have a general understanding of the challenges of achieving a healthy pregnancy naturally at an older age, but are under the impression that women who have difficulties conceiving can, if necessary, rely on fertility treatments such as in vitro fertilization (IVF) to “rescue” their reproductive options.

Unfortunately, this just isn’t the reality. While fertility treatments can dramatically improve the chances for an infertile woman or couple to conceive a child, with IVF being the most powerful fertility treatment available, even IVF is not an effective treatment for infertility due to “reproductive aging.”

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This is because, as a woman gets older, she has fewer eggs and the eggs she has left are less likely to be genetically normal. (Genetically abnormal eggs are typically unable to fertilize or develop properly into a healthy embryo.) We estimate that, in your 30s, around 50% of your eggs are normal; in your 40s, just 10–20%. IVF can prompt the body to produce multiple eggs in one cycle, increasing the chances of finding one or more normal eggs. But there’s a limit; IVF can’t reverse the natural process of degradation that eggs undergo as they age.

When you understand it that way, it’s clear why IVF success rates are low for older women. According to SART’s 2014 statistics, for women 34 or younger, the chance of a live birth resulting from an IVF attempt was 49%; this fell to 38% for ages 35–37, 24% at ages 38–40, 12% at ages 41–42, and just 4% at age 43 or older. In other words, for women younger than age 35, the chance of IVF success was 1 in 2, whereas for women 43 or older, the chance was 1 in 25!

Clearly, IVF does not represent a reliable back-up plan for women who defer childbearing to their late 30s or 40s. The best option for women who may want genetic children later in life is to freeze eggs while they’re young.

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