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Does Age Affect/Impact Success Ratein IVF Treatment?

For couples who have remained childless for years, IVF (in-vitro fertilisation) has emerged as the treatment of choice. Typically, IVF is used as a treatment for infertility – a condition in which the woman fails to conceive despite the couple trying for a year or more. IVF is also suitable for couples who may have genetic problems and wish to prevent this from being passed on to the child.

What is IVF?

In in-vitro fertilisation, mature eggs are taken from a woman’s ovaries to be fertilised with sperm in a laboratory. Later, a procedure is undertaken to place one (or more) of the fertilised eggs (or embryos) in the uterus so the baby can develop. It requires up to three weeks or so for an entire IVF cycle to be done.

A couple’s own eggs and sperm can be used for IVF. Conversely, any known or unknown donor may be tapped to source eggs and sperm. In certain cases, a gestational carrier – a woman who allows the embryo to be implanted in her uterus – may be used.

In couples above 40, IVF is occasionally recommended as the main infertility treatment. IVF could also be an alternative if the woman has health conditions like blocked fallopian tubes, ovulation disorders, endometriosis (which affects the uterus, ovaries and fallopian tubes), uterine fibroids (tumours), inexplicable infertility or some genetic disorder. Or the man may have issues with his sperm, such as a low number, unusual size, shape or changes in its movement, making it difficult for the sperm to fertilise an egg.

An Overview of Rules and Restrictions

In India, however, it’s important to understand the laws and restrictions regarding the age of couples undergoing IVF treatment. Ideally, the woman opting for IVF must be between 21 and 50 years and the man between 21 and 55 years. These age restrictions are primarily to safeguard the well-being of both the mother and the baby.

Given the legal considerations, the upper age bracket for women seeking pregnancy with their eggs is recommended to be about 45 years. If donor eggs are used, this limit is relaxed to 50 years. For men choosing IVF treatment, the maximum age limit is capped at 55 years. Coming to the minimum age, it’s 21 years for both males and females seeking IVF treatment. This ascertains the couple are adults legally and fully capable of making well-informed decisions regarding their fertility treatment.

Legal restrictions apart, the most successful IVF outcomes are possible between 25 and 35 years of age mainly because women generally enjoy a higher ovarian reserve and robust egg quality during this period. As a result, the likelihood of a successful pregnancy is enhanced.

The impact of age on productive IVF outcomes is influenced by several factors, including a woman’s ovarian reserve, the couple’s overall health and fitness levels and advances in medical science. In the first, the ovarian reserve denotes the number and quality of a woman’s eggs, which diminish with age. As younger women have a higher ovarian reserve, the chances of better IVF outcomes are greater. Age apart, the cause of infertility can also impact IVF outcomes.

The health and fitness of recipients exert a substantial influence on ensuring good IVF outcomes. Since older people have more health issues, it impacts the outcome of fertility and pregnancy. Nonetheless, advances in fertility treatment and medical technology make it possible even for older women to conceive via IVF, especially through donor eggs. Nevertheless, these procedures have some risks and restrictions.

Understanding the Risk Factors

One should be aware that IVF can carry the risk of some health problems, both in the short and long term. These include:

  • Procedural complications: After a woman takes medications to encourage the growth of sacs in her ovaries that contain an egg each, a procedure is required to retrieve these eggs. This procedure runs the risk of causing infection, bleeding or damage to an internal organ since a thin, long needle is used to harvest the eggs.
  • Stress: The body, mind and finances could come under stress when the IVF process is prolonged.
  • Ovarian hyper-stimulation syndrome: In this condition, the ovaries can swell and be painful, possibly because of fertility injections given to trigger ovulation.  Often, the symptoms may last for almost a week and could include bloating, mild stomach pain, vomiting and diarrhoea. If the woman becomes pregnant, the symptoms could persist for weeks. In rare cases, this syndrome could cause swift weight gain along with shortness of breath.
  • Miscarriage: The miscarriage rate for couples who use IVF to conceive with fresh embryos is the same as that of people conceiving naturally. This is around 15% for pregnant women in their 20s to more than 50% for females in their 40s. As the age during pregnancy rises, so does the risk of miscarriage.
  • Multiple pregnancies: IVF inflates the risk of conceiving more than one baby. Bearing multiple babies runs greater risks of pregnancy-associated diabetes and high blood pressure, premature labour and delivery, low birth weight and birth defects compared to a single-baby pregnancy.
  • Ectopic pregnancy: In this condition, a fertilised embryo attaches to the tissue outside the uterus, usually in the fallopian tube. In such situations, the pregnancy cannot be sustained as the egg won’t survive outside the uterus. A small percentage of IVF treatments end up with an ectopic pregnancy.
  • Birth defects: The mother’s age remains the principal risk factor leading to birth defects, irrespective of how the conception occurs. But IVFs are linked with a marginally higher risk of a child born with heart problems, digestive issues or other conditions. It is unclear whether IVF or other issues cause this enhanced risk.
  • Premature deliveries and low birth weight: As per current research, IVF can lead to a slightly higher risk of babies being born prematurely or with a low birth weight.

Despite these risks, note that such cases are an exception. Overall, successful IVF outcomes have led to many happy couples cradling their firstborn child with unbridled joy.