Reproductive Capacity in Women at 49 Remains Critical Even When Using Eggs from Younger Donors
A recent study shows that fertility treatments in older women have reduced success rates even when using eggs from younger donors.
The study highlights a significant decline in treatment success after approximately age 49.
Scientists conducting research involving 1,774 women stated these findings challenge the belief that donor eggs can fully ‘reset’ a woman’s biological reproductive clock. However, they emphasized that older couples should not be discouraged from seeking treatment.
The study revealed that women aged 49 and above had twice the risk of miscarriage compared to women aged 35 to 40, while their chances of successful pregnancy were lower.
Experts suggest age-related changes in the uterine lining may be responsible, and future treatments could potentially address these issues.
Reproductive Age
Researchers say that in the future, methods might be developed to predict, preserve, or improve the biological age of the uterus.
According to Dr. Beatrice Cristini, lead researcher at an Italian reproductive assistance center, fertility decline has traditionally been attributed mainly to ovarian issues, so the use of younger donor eggs was believed to ‘reset’ the biological reproductive clock.
“Our findings reveal that the actual situation is more complex,” she said.
The study found women in their mid-thirties to early forties had a 54% chance of conceiving via IVF with donor eggs.
For women aged 49 and above, the pregnancy rate dropped to around 43%. Live birth rates declined from 46% to 32%, while miscarriage rates increased from 24% to 38%.
Researchers also observed age-related changes in the endometrium, the inner uterine lining where fertilized eggs or embryos develop. Although thickness remained consistent, quality declined.
Dr. Cristini urged, “These results should not discourage women from receiving donor egg treatments, as they still hold meaningful chances for many older women.”
“However, patients must be clearly informed that donor eggs cannot fully eliminate the effects of reproductive aging, especially after age 49.”
‘Be Honest with Women’
Sharon Marshall underwent IVF treatments for six consecutive years in her 40s and gave birth to daughter Betsy at 46.
She said, “We see and celebrate people having children in their late 40s, early 50s, or beyond, but we don’t often hear about the pain and struggles they endure.”
“Looking back, I spent much of my 40s sick and depressed. It felt like I lost control over my own body, repeatedly going through the same exhausting process.”
She had vowed to stop trying by age 47 if IVF remained unsuccessful.
“Before succeeding on the seventh try, I experienced two miscarriages,” she recalled.
During pregnancy, she was anxious. “I was never fully confident until my daughter was born.”
She commented on the new study, “Women need honest information about how challenging and difficult getting pregnant can be with increasing age.”
“We have the right to know this.”
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Experts agree that each woman’s uterine and ovarian health varies significantly.
In the UK, there is no legal upper age limit for IVF treatment, while some European countries like Greece set the limit at 54 years.
Age limits for egg donation vary by country. In India, the Assisted Reproductive Technology (ART) Act allows women aged 23 to 35 to donate eggs only once in their lifetime.
In Thailand, egg donors must be between 20 and 35 years old, while Brazil sets the maximum age at 37. In the UK, women can donate or share eggs until age 36.
UK regulators encourage private clinics to ensure thorough assessment of the health of both the mother and the child before treatment.
The UK National Health Service (NHS) guidelines provide up to three IVF cycles for women up to age 40, and one cycle for women up to 42.
The cost of treatments using donor eggs is usually borne by the patient.
In the UK, individuals born from donor sperm, eggs, or embryos registered after April 1, 2005, can request identifying information about their biological donors once they reach 18 years of age.
Image source, Getty Images
The study results were presented at the European Society of Human Reproduction and Embryology (ESHRE) and published in the medical journal “Human Reproduction.”
Professor Borut Kovačič, elected president of ESHRE, stated that researchers are striving to better understand the biological communication between the implanted embryo and the uterine lining.
The study indicates when uterine functionality begins to decline biologically, although it does not define an absolute cutoff age.
“This provides important information for patients and lays a strong foundation for future research aiming to identify biological markers of uterine aging,” he said.
Dr. Ippocratis Sarris, newly elected chair of the British Fertility Society, recommended that older women and couples receive thorough health assessment and appropriate counseling before undergoing fertility treatments due to potential pregnancy risks.