Getting Pregnant Over The Age of 40
A woman is born with all the eggs she will ever have in her lifetime. Unlike a man’s gamete, the sperm which can be regenerated, the woman’s egg reserve is finite and decreases as she ages. Apart from the lower number of egg reserve, the eggs will also age which results in the quality of the egg to decline. This is why women at older age are at risk of miscarriage and genetically abnormal child births. Statistically, a woman has less than 5% chance of getting pregnant when she reaches 40, and almost zero as she approaches menopause (no more eggs).
Is It Possible To Conceive Over 40 Using Own Eggs?
There are 3 known cases worldwide, where women are able to conceive using their own eggs at the maximum age of 46 in Fertility Care Orlando USA, Create Fertility London UK, and Metro IVF Malaysia. With the help of IVF, pregnancy can be achieved.
It was in 2012 when Pn. Lina, a local Malaysian, came to Metro IVF for her first fertility visit. She planned to get pregnant when she was 45. Physical and medical examination showed she had poor ovarian reserve and it would take a miracle for the IVF laboratory to achieve pregnancy for her. During the consultation, she was also informed by the consultant and the fertility counsellor that her chance of getting pregnant is less than 1%. Furthermore there is increased risk of miscarriage of over 20%, risk of abnormal baby and also the risk of hypertention, diabetes, and other medical illneses. She decided to seek other fertility opinions. In 2013, Pn Lina came back and requested to proceed with IVF treatment. She was further counselled on the low chance of achieving pregnancy and other risks.The fertility team worked hard and together with the embryologist and andrologist had a long discussion before proceeding with the case. It was decided that the best stimulation protocol for her would be short IVF protocol (Flare-up) She had 2 follicles and 1 egg. ICSI was done for the single egg to ensure fertilisation. The inseminated egg was then cultured in a mint incubator with mixed gasses and media to ensure optimal progress. The following day, fertilisation was confirmed by the embryologist that there was 2 pro-nucleus and 2 polar bodies. The team knew they have made the right decision.
On the second day, the embryo had divided into 4 cells. The fertility team collectively decided to transfer the 4 cell embryo instead of culturing it further (Although the standard procedure requires cultivation to 3 days or 5 days). In-vitro is better than in-vivo. The embryo transfer was then performed by the most senior and experienced clinician and senior embryologist. The embryo transfer went through smoothly and was placed 1cm from the fundus. The team was relieved as the embryo was placed at the best position. After the transfer, it was decided that Lina should have adequate luteal support to ensure implantation. She was given both progesterone injection and vaginal progesterone. During the three weeks that follow, she was regularly supported by the team of fertility counsellors. 3 weeks later, Pn. Lina was confirmed pregnant and a healthy baby was delivered at term via lower segment cesarean section (LSCS) .
At last, the team of clinicians, embryologists, counsellors at Metro IVF were delighted that all their hard work and time spent was not in vain. It would have taken a few hundred cycles on average to achieve 1 such pregnancy. To date, this is the oldest successful IVF woman to conceive and deliver a healthy baby using her own egg in Malaysia.