If you’re over 45 and wish to become a mum, watch this Online Patient Meeting. Dr Fernando Sánchez
, Clinic Director at Ginemed, Spain, answered patients’ questions about fertility treatment for women after the age of 45.
Dr Sánchez started his presentation by explaining that nowadays, a lot of women postpone their motherhood, and this is not a question of medicine but a social question. We see it on the news every day when an actress or a celebrity over 45 has become a mum, it is a trend that is on the rise. Egg donation treatment is used most by those patients over 45.
Mother’s age & live births rates
The age of when a mother becomes pregnant is increasing, and much older women are looking for treatments nowadays. Birth rates for women in the age group 35-39 started to increase, from the 70s to 2012, and in the age group 40-44, it started to increase in the early 80s. In the group of over 45 years old, even in the 50 years old, it is still increasing even more.
Pregnancy risk assessment
At such an age, there are a lot more risks involved in such pregnancies. Therefore, risk assessment is performed altogether with counselling. This assessment will allow making an informed decision. The risk of preterm delivery is very high in patients over 45, which is at 7.8%. When trying to have a pregnancy at an older age, over 45, a risk score needs to be evaluated. This risk score allows evaluating the risk based on the score. There are low numbers below 0.5, which is a normal score, then the score increases from medium to very high risk, which is up to 2.5, or it is contraindicated, over 2.5.
One of the risk scores is age. At the age of 45-47, it is 0.25 points. Depending on the age, it is then increased to 0.5 and 0.75, and so on.
Other things that also are taken into account are previous conditions, such as BMI (Body Mass Index), smoking, hypertension, and diabetes. Another aspect is the treatment if someone is an anticoagulated patient or had previous uterine surgeries, the score will be increased. Illnesses such as Antiphospholipid syndrome (APS), recurring thrombovascular disease or heart condition.
Also, if you had previous pregnancies with premature delivery at less than 32 weeks or if you have preeclampsia, again, the risk will be higher. Personal evaluation is also considered.
Once this risk score is done, it is shared with other doctors. Generally, we ask for the practitioner or family doctor to confirm if the pregnancy is not contraindicated. Dr Sánchez also added that they discuss this with the gynaecologist just to be sure that this woman who is going to become pregnant is going to have a doctor till delivery, this is very important. With all of these documented risk scores and 2 forms from the general practitioner and the gynaecologist, the committee evaluates the case. The committee then decides whether treatment can be authorized or not and what type of treatment it should be.
Egg donation & women over 45
At the age of 45 and over, the only possibility is to perform an egg donation cycle and a single embryo transfer, just to avoid the risk of twin pregnancy. Genetic matching
with the donor is also performed, as well as with the recipient’s husband or sperm donor.
Dr Sánchez also strongly recommends performing PGT-A
(Preimplantation Genetic Testing for Aneuploidies), to make sure that this embryo is perfect. Plus, it is also important to decide what is going to happen to the remaining embryos, which can be donated to other couples.
The results are shown in terms of pregnancy rate according to a pregnancy test, ultrasound and delivery rate. For the age group between 45-49, the pregnancy rate is 71%, while the delivery rate is around 35%.
For the age group, 50 years and over, the pregnancy rate is around 77%, and the delivery rate is around 50% with single embryo transfer.
YOU MIGHT BE INTERESTED IN
Becoming A Mum In Your Late 40s
Mini IVF: Minimal Hormonal Stimulation in IVF