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.