|
If you have any questions, you may call us at (314) 576-1400.
IVF for Older Women
We are willing to take on the most difficult cases with lower prognosis, so long as we feel there is a chance for pregnancy. Women over 38 years of age often have very few eggs, respond poorly to conventional ovarian stimulation, and because of lower pregnancy rates, are often just cancelled by IVF clinics for fear that such cases will lower their reportable statistics. Also, such patients usually require huge doses of expensive drugs that can add another $6,000 or $7,000 to the already high cost of conventional IVF, bringing total costs to as much as $18,000 or more per cycle.
Of course, one option for such women is donor eggs, but many women would prefer getting pregnant with their own eggs. The best solution for such patients is the Japanese mini-IVF protocol.
Mini-IVF, first developed by the Kato Ladies Clinic in Japan (close colleagues of ours) and popularized at St. Luke's Hospital in St. Louis, is just the right approach for older women or women with low ovarian reserve who still want to use their own rather than donor eggs. It takes advantage of your own natural FSH elevation with an ingeniously simple protocol that strives for smaller numbers of better quality eggs. Instead of massive doses of expensive hormones to try to blast out a few poor quality eggs, it more naturally teases out of the older ovaries their best quality eggs with a carefully devised protocol of minimal stimulation. There are no symptoms of huge hormonal swings or hyperstimulation. It is easier on the patient and much cheaper than conventional IVF.
For younger patients its success rate is almost comparable to conventional IVF but dramatically cheaper. For older women with lower ovarian reserve, the success with mIni-IVF is far superior and also cheaper than conventional approaches.
Let's give a few examples:
A 43 year old woman who married relatively late in life was told by numerous doctors and infertility clinics that she could only get pregnant if she used donor eggs, and some also recommended donor sperm because of the husband's age (which was silly). However this couple was only interested in having a child from their own sperm and eggs. We placed her on a program of mini-IVF back to back cycles to store up embryos by vitrification over the next year. We were only able to attain one egg (and one embryo, therefore) with each cycle. After four embryos were finally stored up, we transferred two thawed embryos at a time in subsequent months, and with the second embryo transfer, at age 44, she became pregnant with her own eggs and delivered a healthy baby boy.
Another example: A 43 year old woman married, at age 38, to a 34 year old man, already had conceived naturally and delivered a healthy son four years earlier. Now the couple wanted a second child and had been told that donor eggs was her only option because of her age and low ovarian reserve. But they were definitely not interested in their son's sibling having a different maternal DNA origin than his. So we put her through two cycles of mini-IVF back to back, and stored up three embryos retrieved from her own eggs, only one of which looked viable. One half year later we thawed that single embryo and transferred it to her uterus. She became pregnant and delivered a healthy baby at age 44 without having to resort to donor eggs.
Another example: A 41 year old nurse married to a 39 year old physician had already gone through three conventional IVF cycles elsewhere with PGD and no success. So they were recommended to use donor eggs for her next (fourth) cycle, but they were just not ready for this option. In desperation they underwent three back to back cycles of mini-IVF with us (at about one fifth of what she spent in her previous IVF's), obtaining two eggs each time, resulting in six stored up frozen embryos [video] . We transferred two at a time the next year, and she finally got pregnant with her final embryo transfer.
There are many more such examples where persistence and mini-IVF can be successful with older couples. The advantage of mini-IVF is that we can get better quality embryos at a much lower cost per cycle, store them up safely with vitrification, and spend less than the conventional IVF cycles would cost. Nonetheless, some women simply will not have any viable eggs of her own, and then donor eggs becomes the only remaining option.
Donor Eggs
If a woman absolutely cannot get pregnant with her own eggs, then donor eggs is her only remaining option. Actually, although not her first choice, it is nonetheless a very good option. We have been offering donor egg IVF for over 24 years, and therefore have had a chance to follow these children and their parents for a almost a quarter century. Both the children and the parents are well adjusted and completely happy with their lives as a result of the donor egg IVF. In fact, these wonderful outcomes convince me that in the controversial nature vs. nurture debate, nurture is the clear winner. The reason it is so often misunderstood is that what appears to be ingrained character in a child is in truth, a subtle result of early interaction with parents in the first two or three years of life. The character, personality, intelligence, and even coordination motor skills of the child are dependent on that emotional bonding and complex interaction with parents in the first few months and years. So couples who have to take their second choice, donor eggs, because they have run out of their own eggs, should not be forlorn. Donor eggs are a great option for them.
How does it work and how do you select an egg donor? Many IVF programs just have a small local pool of egg donors, which we feel is not a favorable approach. We work with a variety of specialized donor agencies all around the U.S. encompassing every geographic region and every ethnic and racial group so as to give the couple with ovarian failure the largest possible choice. We do all the medical work and screening, but the infertile couple does the choosing based on detailed characteristics and appearance of the donor. However, for psychological reasons, we feel it is best for both the donor and recipient to remain anonymous to each other, although an occasional couple will prefer a known donor. In either event, if you are forced by complete lack of any fertile eggs of your own, to use donor eggs instead, in the end you can feel quite comfortable that you can still have a very happy and fulfilling family.
See also:
If you have any questions, you may call us at (314) 576-1400.
|
