Women
aged 49 and above are significantly less likely to achieve a successful
pregnancy through fertility treatment, even when using eggs
donated by younger women, according to new research that challenges long-held
assumptions about reproductive ageing.
The study, which analysed 1,774 women undergoing in vitro fertilisation
(IVF) with donor eggs, found that while donor eggs improve the chances of
conception, they do not completely offset the effects of ageing on the uterus.
Researchers reported that women aged between 35 and 40 had a 54 per cent chance of becoming pregnant following IVF with donor eggs, compared with about 43 per cent among women aged 49 and older. Live birth rates also declined from 46 per
cent to 32 per cent, while miscarriage rates rose from 24 per cent to 38 per cent in the older age group.Lead researcher Dr Beatrice Crestani of an assisted reproduction medical
institute in Italy said the findings suggest reproductive ageing extends beyond
the ovaries.
“For many years, reproductive ageing has largely been viewed as an
ovarian issue, with the assumption that replacing older eggs with younger donor
eggs effectively resets the reproductive clock. Our findings suggest the
picture is more complex,” she said.
According to the researchers, age-related changes in the endometrium —
the lining of the womb where an embryo implants — may help explain the reduced
success rates. Although the thickness of the womb lining appeared similar
across age groups, its overall condition declined with age.
The
researchers believe future studies could lead to ways of predicting, preventing
or improving age-related changes in the womb, potentially enhancing fertility
treatment outcomes for older women.
Despite the findings, Dr Crestani stressed that women should not be
discouraged from pursuing donor egg treatment.
“Success rates remain meaningful even at advanced ages. However,
patients should be counselled that donor eggs cannot completely eliminate the
effects of reproductive ageing, particularly beyond the age of 49,” she said.
The study also found that when all available embryos were transferred,
cumulative live birth rates were around 80 per cent for women aged 35 to 40,
compared with 62.5 per cent among women aged 49 or older.
The findings resonate with the experience of television broadcaster
Sharon Marshall, who underwent six years of IVF treatment before giving birth
to her daughter at the age of 46 after seven treatment cycles.
Marshall said public attention often focuses on celebrities who have
children later in life without highlighting the emotional and physical
challenges many women endure.
“We look at celebrities who have given birth in their late 40s and early
50s and celebrate them. We don’t know what they have been through,” she said,
adding that repeated IVF attempts took a significant toll on her physical and
mental wellbeing.
She
welcomed the study, saying women deserve honest information about the realities
of trying to conceive at an older age.
Experts cautioned that fertility and uterine health vary from person to
person, and the age of 49 should not be viewed as an absolute cut-off. Instead,
they said the findings provide valuable evidence for counselling patients and
guiding future research into uterine ageing.
Professor Borut Kovacic, Chair-elect of the European Society of Human
Reproduction and Embryology (ESHRE), said the research offers an important
foundation for understanding how the womb interacts with an implanting embryo
and may help identify biomarkers associated with uterine ageing.
Dr Ippokratis Sarris, Chair-elect of the British Fertility Society, also
called for further research, noting that pregnancies at older ages carry
additional health risks and require comprehensive medical assessment and
counselling.
The findings were presented at the European Society of Human
Reproduction and Embryology annual meeting and have been published in a medical
journal.
(BBC News)
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