IVF Cannot Counteract Age-Related Loss of Fertility in Women Older Than Age 40
January 15, 2009
National Partnership for Women & Families
In vitro fertilization cannot reverse the effects of aging on fertility in women older than age 40, but the procedure does give infertile women younger than age 35 the same chance of having a child as their fertile peers, according to a new study by Harvard Medical School researchers in the New England Journal of Medicine, the Washington Post reports. The study analyzed data from 6,164 patients who underwent 14,248 cycles of IVF between 2000 and 2005 at a Boston clinic. According to the Post, it is the most extensive assessment to date of the chance of giving birth after IVF for women of various ages. Researchers found that the cumulative live-birth rate after six cycles among women of all age groups was 72% when researchers assumed that patients who did not continue IVF cycles would have the same chance of a live birth as patients who continued with IVF. A more conservative analysis, which assumed that there were no live births among patients who did not return for additional cycles, found that the success rate was about 51%. Lead author Alan Penzias said that the actual rate is probably somewhere between the two estimates. According to Penzias, the new study is the first to examine a widespread population of women, including older women and women who used both fresh and frozen eggs. Penzias said, "Among the younger women, it was nice to see that we are able to put them back in the same category as their fertile peers." He added, "For older women, we can restore [them] back to the same chance as fertile women of [their] age, but we can't make everyone have the same fertility as a 35-year-old. IVF does not reverse the clock." The Post reports that the reason IVF cannot reverse age-related infertility is that the procedure can help women who are infertile because of blocked fallopian tubes or endometriosis, but it cannot counteract aging effects on a woman's ovaries or eggs. Treatment for older women therefore is limited to using eggs donated by a younger woman.
According to the Post, infertility clinics commonly report their success rates as a percentage of patients who become pregnant in each cycle of treatment -- which does not answer the question of what chance a woman has of giving birth after a full course of multiple treatment cycles. Penzias said that the new study provides women with a more accurate estimate of their chances of giving birth through IVF. "One of the sad states of affairs is that there are many women who are not aware that there is an effect of aging," Penzias said, adding that births to older celebrities and the fact that infertile women typically "feel otherwise healthy" contribute to the misconception. Mark Rothstein, a bioethicist at the University of Louisville, said, "People have been given an overly rosy picture of the ability of fertility science and medicine to do almost anything," adding, "Part of it may be overselling by the clinics. Part of it may be denial and wishful thinking." Elizabeth Ginsburg, president of the Society for Assisted Reproductive Technology, said that the new findings offer helpful information but that it would be difficult for clinics to report their data to CDC in the same way as the Boston researchers. She added that the study "gives patients who persist with their treatments an idea of what their chances of success are. It shows that if they are older, they should lower their expectations" (Stein, Washington Post, 1/15).
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