When IVF doesn’t work…

You may have heard in the news recently about the latest statistics on IVF success for women in their forties, and seen that Sally Cheshire, Chair of the fertility regulator the Human Fertilisation and Embryology Authority (HFEA), has spoken out about the need for fertility clinics to be more honest and open with patients about their chances of IVF success.

The latest figures show that the number of women in their forties having IVF has doubled since 2004, but only 75 women aged 42 and 43 will get pregnant using their own eggs, and once you reach the age of 44, just two women a year are successful. To put that into context, approaching 11,000 women who were over 40 had IVF in 2017.

Some clinicians say that women are entering into IVF with their eyes open, well aware of the chances of a successful outcome, but you don’t have to talk to many women who have had IVF to know that is often far from the case. When you are longing for a baby, you tend to hear the positives rather than the negatives, and when there’s a 5% chance of success, it’s the 5% you focus on rather than the 95% chance of your treatment not working.

It is difficult as sometimes women feel that although they may be 44 or 45 and know it is unlikely that treatment will work, they still want some kind of closure and need to know they’ve done everything they possibly could.

Sally Cheshire talks in her interview about being approached by clinics at the Fertility Show in Manchester and being given unrealistic suggestions of her chances of having successful IVF treatment. It is vital for clinics to be honest about this – and it doesn’t take much searching to find clinics publishing clinical pregnancy rates for women in their mid-forties which many will see as their chance of having a baby – when in fact, miscarriage rates are high for women of this age and these clinics know only too well that the live birth rate is very different from the clinical pregnancy rate.

You can read more about Sally Cheshire’s interview with the Telegraph here

New advice to women of 44 and over doing IVF

eggFor women who are going into IVF in their mid-forties, the chances of success are not good and now new research from  Dr Marta Devesa from Barcelona has led her to suggest that women who are 44 and over should be advised against trying IVF with their own eggs.

What does the research conclude when it comes to IVF  for older women ?

Her study, which has taken 12 years to complete, looks at birth rates following IVF at her clinic and shows that the cumulative rate for women aged 44 and over using their own eggs is just 1.3%. The success rates for women using donor eggs do not decline with age in the same way – leading to the conclusion that it is the age and quality of the egg which is the key factor rather than the age of the woman herself.

Dr Devesa explained that the most likely biological reason for a decline in live birth with female age was chromosomal abnormalities in the embryo.

You can read more about her research and her findings here 

Fit and healthy doesn’t always mean fertile

I was listening to a woman talking yesterday about access to IVF for women in their mid-forties. She thought the NHS should fund treatment for women who were past the age of 42 (which is the current cut off recommended by NICE) if they were “fit and healthy”.  It’s a point of view that some may share – that age isn’t as important as how you look after your body and that those who eat well, who exercise and who appear younger than their years must still be fertile.

In fact, fertility doesn’t work that way; of course, being fit and healthy is always going to help, but by the time you reach your mid-forties, it’s your personal biological clock which is more important when it comes to your chances of conceiving –  and that’s not something that any amount of healthy eating can alter.

The HFEA success rates for IVF show this very clearly; women who are 35 and under have an average chance of success of 32% but for 38-39 year olds this is already reduced to 20%.  Once you get into your forties, the decline is very sharp – for a woman of 40-42 there is a 13% chance of success, at 43-44 that drops to 5% and over 45s have a less than 2% chance of getting pregnant with IVF.  So no matter how fit and healthy you may feel, your chances of IVF success in your mid-forties are very low.

It’s a difficult message, and one that we don’t always want to hear – but the one thing IVF cannot do is turn back the biological clock.