Female fertility begins to gradually decrease after the age of 30, and even more rapidly after the age of 35. However, most healthy women who get pregnant after the age of 35 or even 40 can have healthy babies.
Women above 35 years of age may need to undergo certain forms of assisted reproductive methods, such as in vitro fertilization or IVF if they are unable to conceive naturally. With many women opting to delay pregnancy due to professional reasons, IVF has gained immense popularity among older women who wish to get pregnant.
In vitro fertilization or IVF is a type of fertility treatment in which the mature female eggs are retrieved from a woman’s ovaries and manually combined with the male sperm in a lab for fertilization. The fertilized egg or embryo is then placed inside the woman’s womb or uterus. Pregnancy takes place when the embryo implants itself into the wall of the uterus.
The basic steps involved in an IVF process are as follows:
- Stimulation or super ovulation: Fertility drugs are given to the woman undergoing IVF to boost the production of female eggs.
- Egg retrieval: This step involves the use of an ultrasound by the doctor to insert a thin needle through the woman’s vagina into the ovary and sacs or follicles containing the female eggs. The needle will be connected to a suction device, which will pull the female eggs and fluid out of each sac, one at a time.
- Insemination and fertilization: This step involves the placement of the sperm of a man with the best quality of female eggs. The mixing of the male sperm and female egg is known as insemination. The eggs and sperm will then be stored in an incubator. The sperm usually enters the female egg a couple of hours after insemination, known as fertilization. Alternatively, the doctor may inject the sperm directly into the female egg, known as intracytoplasmic sperm injection or ICSI.
- Embryo culture: Once the fertilized egg divides, it turns into an embryo. The growth of the embryo is monitored carefully. After approximately five days, a normal embryo will have many cells that will be actively dividing.
- Embryo transfer: The embryos are placed into the womb of the woman three to five days following egg retrieval and fertilization.
We will now be discussing the five important things that you need to know about having a baby after 35 years of age.
I. IVF and Age
Just like female fertility reduces with age, IVF success rates also tend to reduce with age. This is because as a woman ages, the quantity and quality of female eggs diminish, also known as low ovarian reserve. This may lead to poor embryo quality, which reduces the chances of implantation occurring within the uterus.
According to the Society for Reproductive Technology or SART, the approximate percentage of live births using a woman’s own eggs by the IVF technique is approximately 55.6% for women less than 35 years of age, 40.8% for women between 35 and 37 years of age, 26.8% for women between 38 and 40 years of age, and 7% for women above 40 years of age, with a higher rate of success for women under 42 years of age. Many women above 40 years of age may decide on using donor eggs of females in their mid-20s to eliminate the age factor in determining the success of pregnancy.
II. The Role of Fertility Specialists
Couples who are trying to conceive naturally but are unable to do so even after trying for a year should consult a fertility specialist to be able to conceive successfully. For couples who are above 35 years of age, this window is even shorter and they should consider consulting a fertility specialist after trying to conceive naturally for six months.
A fertility specialist will first recommend certain screening tests for both, the male and female partners. Based on the results obtained, the doctor will diagnose if there are any fertility problems and recommend fertility treatment options to the couple to help them conceive.
IVF treatment is a commonly recommended type of fertility treatment option for women above 35 years of age who are unable to conceive naturally or couples with other fertility problems. The fertility specialist will make a customized treatment plan for the couple based on their fertility and overall health evaluation.
III. Preparing for IVF After 35
Besides undergoing the screening tests recommended by the doctor, the woman undergoing IVF treatment needs to undergo the following preparatory steps:
- Consume a well-balanced and healthy diet
- Start prenatal vitamins, as recommended by the doctor
- Maintain a healthy weight
- Quit smoking
- Stop alcohol consumption
- Avoid the use of any recreational drugs
- Limit caffeine consumption
- Avoid traveling to countries or areas that may put you at increased risk of exposure to infectious diseases
- Manage anxiety and stress by using techniques like yoga, acupuncture, meditation, or joining a support group
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IV. Potential Challenges and Risks
IVF treatment in older women may lead to certain complications. The common risks associated with IVF treatment are:
- Premature delivery
- Multiple births
- Birth defects
- Low child birth weight
- Ectopic pregnancy (when the fertilized egg implants outside the woman’s uterus)
- Complications during retrieval of female eggs, such as infection, bladder damage, bowel damage, or damage to the reproductive organs
- Ovarian hyperstimulation syndrome, which is a rare condition causing stomach pain, nausea, diarrhea, vomiting, rapid gain of weight, shortness of breath, bloating, and inability to urinate
V. Financial Considerations
IVF treatment is an expensive procedure and one needs to take into consideration the cost factor before opting for the procedure. The average cost of IVF treatment in Mumbai varies between INR 1,00,000 to INR 5,00,000.
The cost of IVF treatment varies depending on the following factors:
- Type and technique of IVF procedure
- Age of the patient
- Medical history of the patient
- Location and reputation of the clinic
- Expertise of the fertility specialist
- Cost of medicines and other medical consumables
- Number of IVF cycles needed before achieving a successful pregnancy
- Need to undergo additional procedures
Most health insurance policies in India do not cover the cost of an IVF procedure since it is an elective procedure rather than a medical necessity. However, some insurance policies may cover diagnostic tests and certain other procedures related to IVF treatment. You should contact your medical insurance company to check what is included in your policy. The decision to undergo IVF treatment can be taken after getting an estimate of the out-of-pocket expenses you will need to bear for the procedure.
The fertility of a woman decreases with age. A woman above 35 years of age who is unable to get pregnant naturally should consult a good fertility specialist to assess her reproductive health and discuss the various fertility treatment options available.
IVF treatment is a popular assisted reproductive technique used to help older women to conceive. However, the procedure is expensive and can lead to different complications which may involve physical, emotional, and financial challenges. It is best to talk to your fertility specialist before starting with IVF treatment.