Fertility Outcome in the Older Patient
Women are born with all of the eggs they will ever have as compared to men who make new sperm continuously. These eggs suffer the consequences of aging as do the other cells in our bodies. Scientific evidence suggests that as eggs age, their quality decreases and the likelihood of genetic abnormalities increases. This is translated into a decline in fertility and an increase in miscarriages and risk of genetic abnormalities as the woman ages. Nothing suddenly happens on the 35th or 40th birthday, but the decline in fertility is logarithmic and decreases rapidly in the late 30's and 40's. True menopause is that time when she runs out of functional eggs.
In making decisions to pursue fertility therapy, you should have an understanding of how your age affects your prognosis. There is essentially no evidence that male age has an impact on fertility. Below are the statistics reported in May, 2004 of year 2000 outcomes by the Society of Assisted Reproductive Technology and the American Society of Reproductive Medicine* to use as a guideline in making your personal decision.
IVF Procedures Without ICSI
- Women <35 no male factor infertility 36.7%
- Women 35-37, no male factor infertility 31.8%
- Women 38-40 no male factor infertility 23.2%
- Women >40 no male factor infertility 10.5%
IVF Procedures With ICSI
- Women<35, male factor infertility 36.2%
- Women 35-37, male factor infertility 30.8%
- Women 38-40, male factor infertility 22.2%
- Women >40, male factor infertility 10.1%
GIFT procedures yield similar results with delivery rates per retrieval with no male factor of 32.7, 23.8, 28 and 10% respectively and when male factor is present rates of 30.3, 26.7, 11.1 and 14.3% respectively. When donor eggs are used the pregnancy potential is based on the age of the egg donor and any other infertility issues that may be present averaging about 40-50%.