A delayed pregnancy is a way to have a baby at a relatively late age without resorting to the use of donor eggs. In this case, IVF is also performed, but the woman’s own genetic material is used – an egg that was extracted in advance, during the fertile period, and frozen for the storage period.
The process of in vitro fertilization is divided into 2 stages, which are separated in time:
Genetic material is being prepared. The woman undergoes an examination, then doctors stimulate her ovaries and obtain oocytes in large quantities. Oocytes are frozen in liquid nitrogen and stored in a cryobank until required.
Fertilization is carried out. The patient again undergoes diagnostics, which allows us to identify possible, newly emerging diseases or contraindications, and then, if necessary, treatment. When the body is ready, the harvested germ cells are thawed and also examined for damage. Cells suitable for fertilization are treated with harvested sperm. As a result, embryos develop and are transplanted into the woman’s uterus. She naturally carries and gives birth to a child.
Thus, a healthy child can be born even to an infertile woman with a hereditary early menopause.
Often, this reproductive technology is used by those who want to safely postpone childbearing until they have settled into a career or personal life. The technology, firstly, guarantees biological (and not just legal) parenthood, and secondly, it is simplified compared to the method of using donor eggs.
Donating your own oocytes for storage is much cheaper and easier than finding suitable donor oocytes, the chance of getting pregnant with them is the same as naturally, and cryopreservation keeps them intact indefinitely.
Examinations for IVF after 40 years
High-quality diagnosis of a patient over 36 years of age plays a key role when performing in vitro fertilization. The examination includes a set of standard procedures:
Donating blood for tests – general, “biochemistry”, for antibodies, hormones, diseases, etc.
Submission of urine for tests – general, biochemical, hormones (especially AMH, FSH).
Examination of a vaginal smear or cervical scraping (microflora, oncocytology).
Ultrasound of the pelvic organs.
Also, due to the possible age characteristics of the patient, a number of additional examinations are required. These include preimplantation genetic diagnosis of eggs (embryos).
In addition to the patient herself, the father of the unborn child – the husband or sexual partner of the woman – is examined. It follows a simpler principle, since only healthy sperm are required from a man for the procedure. Diagnosis of his health includes:
blood tests – general, biochemical and for the presence of infections;
submitting urine for general analysis, “biochemistry”;
conducting a spermogram (determining the fertile properties of sperm – how many sperm are in the ejaculate, what their morphology is, how mobile they are, etc.).
If the quality of sperm is initially low and there is a risk of fertilization failure, the doctor prepares it – increases the concentration per unit volume. Or it selects the healthiest, most mobile sperm, which then forcibly penetrates the egg.
During pregnancy, as well as after childbirth, a more thorough than usual examination of the health of mother and child (the child for at least the first year of life) will also be required.
Features of IVF in women over 40 years old
Woman’s physiology changes over time, and in connection with this, medical approaches change when examining before conception, during pregnancy management, during and after childbirth.
So, for women over 40 years old:
ovarian stimulation for in vitro fertilization may not be carried out or carried out in a relaxed version (since the ovarian reserve is usually depleted);
for 1 IVF attempt, 1 embryo is transferred to avoid multiple pregnancies – even for younger women it is associated with a large number of risks;
after implantation, the woman undergoes maintenance hormonal therapy – this ensures that the body has the amount of hormones necessary for a favorable pregnancy (due to age, this amount in the body is reduced).
Depending on the state of the body, the number of attempts at fertilization is often limited in order to prevent the development of health problems (which in any case can complicate the process of pregnancy and childbirth).
However, according to some data, after 40 years, at least 15% of IVF cases – on the first attempt – give successful results, and if you use several attempts, or even a donor egg, the chances of a successful outcome of pregnancy and childbirth are higher.
IVF at a late age and ethical issues
Ukraine is one of the countries where the legislation is liberal regarding in vitro fertilization methods. This matters from an ethical point of view (from a medical point of view, everything is justified).
In a number of states, a ban is imposed on the procedure for “age” women, either legislative or unofficial. This is explained by concern for women’s health:
The body’s capabilities are often limited due to natural processes, and there are often chronic diseases. With such introductory IVF, even with gentle stimulation of the ovaries, it can seriously harm health and even lead to death.
When using the patient’s own eggs, which were not frozen in advance, but obtained immediately before artificial insemination, the risk of miscarriage increases (and in the born child, the risk of hereditary pathologies).
From an ethical point of view, the danger for both the woman and her child is too great and unjustified, and therefore, according to doctors in these countries, it is better not to carry out the procedure. Moreover, statistical data, which indicate the successful course of processes and good results of IVF, do not affect the effect of the ban.
By the way, there is a nuance associated with the development of several embryos based on the results of fertilization. Subsequently, some of them are artificially frozen at the discretion of the doctor (their development is stopped) so that the rest have more resources for development. This situation is unacceptable for adherents of a number of religions.
In Ukraine, there are no age restrictions for women when undergoing IVF; any patient over 40 years of age can receive appropriate medical care. However, it is still worth remembering about common sense (after the age of 60, for example, in vitro fertilization is usually inappropriate for a number of obvious reasons).
Therefore, in many institutions, women are sent to preliminary consultations, where they are warned about all the risks, speak honestly about the chances of a successful birth of a healthy child, and also offer other options for solving the problem of infertility – for example, adoption. All these measures allow, among other things, to avoid unjustified financial expenses.