Let a child be!

The EmbryLife Center offers a whole range of services for diagnostics and treatment of both female and male infertility. Our specialists use American IVF technology: we work according to guidelines that have shown proven results in thousands of US patients. This technology has implicit excellent laboratory equipment capabilities, in strict compliance with ASRM (American Society for Reproductive Medicine) and ESHRE (European Society of Human Reproduction and Embryology) requirements.

EmbryLife is the only clinic in Russia that has been accredited by the American Association of Embryologists.

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35 Sadovaya St., St. Petersburg, Russia

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IVF effectiveness in different age groups.


IVF effectiveness in different age groups. Two key factors determining IVF effectiveness:

  1. 80% of the IVF effectiveness depends on the “quality” of the embryo to be transferred into the uterine cavity.
  2. 20% of the IVF effectiveness depends on the endometrial condition, or, in other words, on the endometrial readiness to accept the embryo.

IVF babyCurrently, the second factor seems to be the most vulnerable, i.e., the least predictable. This may be due to the following:

  • By now, science has made good progress in studying embryonal “quality.” The EmbryLife Clinic uses the latest, up-to-date embryonal study methods that have already proven themselves. The technologies are undoubtedly capable of significantly influencing IVF procedure efficiency but only from the perspective of the embryonal “quality” assessment..
  • The endometrial condition still remains a problem.  It may certainly be “conditioned” for an IVF procedure, however, it is still impossible to influence the situation after embryonal transfer into the uterine cavity, to predict the further result.

Let us consider some interesting figures demonstrating how a woman’s age influences her reproductive function and also factors determining IVF efficiency

Age of a woman and follicular count:

  • a new-born girl has about 2,000,000 primordial follicles in her ovaries
  • by puberty (sexual maturation), their number decreases to 400,000
  • by age 37, there are only 25,000 follicles
  • in menopause, fewer than 1,000 follicles remain

Immature (primordial) follicles begin developing in a girl before her birth, from the 12th through 28th weeks of intrauterine development and are like “embryos” of the follicles. The dimensions of the primordial follicles (Primordialfollikel) do not exceed 0.05 millimeters. They have a complex structure: an immature oocyte surrounded by one or two layers of cubical epithelial cells.  Girls do not develop new follicles after birth.

The follicle and oocyte quality and the age of a woman:

During a woman’s life, only an insignificant share of the follicles is activated, and most of them die in an inactivated state. Therefore, a woman’s reproductive function is determined by the life duration of her primordial follicles. Oocyte quality changes with time as well: they undergo aging processes and are affected by ambient factors. Consequently, not only the number of oocytes but also the quality is reduced as a woman ages. It is a well-known fact that after age 35, the risk of having a child with chromosomal pathology (Down’s syndrome) increases.

And according to the latest pre-implantation genetic diagnostics studies, the aneuploidy (embryos with a pathological chromosomal set) rate increases significantly with age.  These embryos are not viable, and pregnancy most often does not occur in the IVF protocols, or, if it does, it is followed by an early abortion. Here is some historical data: the photo shows data of a study conducted from 2009 through 2014 with participation of 1,800 women from 18 to 48 years old; 40,000 embryos were analyzed. According to the results, the average share of euploid embryos remains constant - about 55% of embryos in the blastocyst stage. And the number of euploid embryos begins falling dramatically after age 35. As seen on the graph, by age 45, the percentage of embryos with normal chromosomal set is not more than 5%.

This indicates that the share of healthy embryos even in a young 18-year-old girl is not more than 55%. This also serves as a warning that after age 35, the percentage of aneuploid embryos (embryos with pathologic chromosomal sets) increases dramatically each year, and the IVF effectiveness decreases. For example, at the age of 35 to 37, there are 67% of such embryos, after age 40 - 80%, and after age 42 - 95%.

Since we now have up-to-date methods for embryonal chromosomal diagnostics, I would recommend that women, especially those in the older age group, undergo PGS, pre-implantation genetic screening of embryos, so that only healthy euploid embryos are transferred into the uterine cavity. This will certainly lead to a large number of transfer cancellations, but it will also significantly increase IVF effectiveness even in those in the older age group.

Summing up, let us note that science does not stay still, and new testing methods enhancing IVF effectiveness are being developed.  However, because of the very high cost, they are unfortunately not affordable for everyone who wants it. Let us hope that in the future they will become more affordable and maybe will be covered by compulsory medical insurance.

                       

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