Challenges faced by 40+ women when trying to get pregnant are twofold:
1- Every woman is born with a finite set of ovarian reserves. Starting with puberty, these reserves start to decline every month with the menstrual cycle. Around the age of 37, the number of follicles (cysts which contain the eggs) drop down to less than one percent of what it was at birth. Therefore, the ovarian reserves will have declined to very low levels by the time a woman turns 40 years of age.
2- Just like any other cell in our bodies, egg cells also age. The aging oocyte (egg) is associated with several problems including mitochondrial dysfunctions, aneuploidy and epigenetic changes. Mitochondria is the power source of any cell. Any dysfunction in mitochondria is going to affect cellular energy and development. Aneuploidy refers to chromosomal problems, which is the main factor explainign why women in older age brackets are more likely to have miscarriages or deliver babies with chromosomal abnormalities such as down's syndrome (Also see our Cytoplasmic Transfer page for more information on how we can use donor cytoplasm in order to improve IVF success in older age brackets).
In summary, both the quality and the quantity of eggs decline to very low levels by the time a woman reaches 40 years of age and this affects both her ability to become pregnant and to become pregnant with a healthy baby.
One of our recommendations for patients in 40+ age bracket is embryo banking. Embryo banking refers to undergoing a number of IVF cycles with one embryo transfer scheduled at the end of the last cycle. For instance, a patient can have one IVF cycle where we collect her eggs, fertilize with the partner's sperm sample and freeze the resulting embryos. Once ther patient undergoes a second cycle, we repeat the same process and obtain more embryos. This can be repeated 2 or 3 times until a desired number of embryos have been reached.
Once the ideal number of embryos has been reached, the embryos can be incubated to the blastocyst stage and the ones that reach this stage can either be transferred into the uterus for pregnancy, or, they can be screened via pre-implantation genetic screening (PGS) method in order to check the chromosomal integrity of the embryos. Once PGS has been performed, the healthy and chromosomally euploid embryos can be selected for embryo transfer.
Embryo banking allows us to increase the number of embryos available for embryo transfer. This coupled with PGS will also allow us to make sure the embryos being transferred do not have chromosomal problems.
For more information, please contact us.
One of the main problems facing IVF patients over 40 years of age is the decline in ovarian reserves. Every woman is born with a finite number of ovarian follicles and while a very small number of these follicles succeed in becoming a mature egg, majority of the rest of the follicles never reach ovulation and are disposed with every menstrual cycle. Around the age of 37, the decline in ovarian reserves becomes very sharp.
As a woman gets older, declining ovarian reserves is not the only problem faced in fertility. As age gets older, so do the follicles in the ovaries. Therefore, another problem called "oocyte aging" becomes more pronounced. This is in fact one of the main reasons why women above the age of 40 are more likely to experience a miscarriage- An aging oocyte will be associated with a number of genetic problems, causing the baby to have genetic mutations, thus leading to a miscarriage.
At North Cyprus IVF Center, we offer a comprehensive treatment approach for 40+ patients, which combines a number of important considerations in terms of ovarian reserves and oocyte aging. Patients who still ovulate, and who still have a minimal level of ovarian activity are ideal candidates for our 40+ treatment program. It is important that the female patient still has at least 1/2 pre-antral follicles to be recruited via controlled ovarian hyperstimulation so that we can offer a chance of success with own eggs. For patients with no ovarian function, then using an Egg Donor becomes the only option.
#1- Cytoplasmic IVF Treatment: Patients who still have a few oocytes, but cannot get pregnancy with those oocytes due to oocyte aging can possibly benefit from our cytoplasmic IVF treatment. The principle here is, we use the genetic material from the patient, but we provide the non-genetic parts of the egg from an egg donor so that the patient's own eggs have a friendlier host for optimal growth. It is a known fact that the mitochondria found in the cell's cytoplasm is responsible for cellular energy production and cell growth. By providing the patient's eggs with donor mitochondria, we allow the eggs to grow more optimally and become more viable.
#2- PGS for Genetic Screening: While Cytoplasmic IVF Treatment will allow your eggs to be more viable with higher fertilization potential, it will not be able to eliminate potential genetic risks associated with the age of the patient. Therefore, pre-implantation genetic screening is a good idea to make sure only the genetically correct embryos are transferred into the uterus. Keep in mind that we are not aiming for just any pregnancy. We are aiming for a healthy and viable pregnancy.
#3- Embryo Batching: Given that IVF treatment after a certain age will only allow us to have just a few eggs, any method that will allow us to get more eggs will increase our chances of success. Therefore, while we will be providing your eggs with a better host for optimal growth via cytoplasmic transfer, we still need a certain number of eggs so that we can make sure in the end we have at least one well-grown, genetically correct embryo to transfer. Embryo batching is the key component of success in this age bracket. Combining two rounds of IVF cycles into one allows us to get double the number of eggs- Essentially, what we do is, we prepare you for one round of IVF cycle where we collect the eggs, infuse them with donor cytoplasm, fertilize into embryos and freeze. Once you are ready for the second round, we collect another set of eggs, repeat the same procedures and make a new batch of embryos. With the two sets of embryos at hand, we proceed with pre-implantation genetic screening (PGS) and select a chromosomally normal embryo for transfer, thus giving you the maximum chance of success possible using your own eggs.
We give your eggs the maximum chance of survival through cytoplasmic transfer - we collect two rounds of eggs to increase your likelihood of success by creating multiple embryos - We make sure the embryos to be transferred are chromosomally euploid through PGS testing. This is how we are able to offer you the maximum chance of success possible with your own eggs.
Contact us for more information.
Dr. Savas Ozyigit
Egg donation in Cyprus, Gender selection in Cyprus and IVF treatments in North Cyprus in general: you will find information on new advances in IVF technology and latest IVF practices. All the blogs are personally written by Dr. Savas Ozyigit and his expert medical team.