March 1, 2012 (New York, NY) – Center for Human Reproduction (CHR), a leading New York fertility center specializing in pregnancy in older women, has issued a fertility tip sheet for women trying to get pregnant after age 40. With a growing number of women interested in pregnancy over 40, timely evaluation and diagnosis of infertility are becoming ever more important. However, they remain elusive for many patients.
“It’s important to recognize the urgency of aggressive fertility treatment when you are above age 40,” says Dr. Gleicher, Medical Director of CHR, which released the tip sheet. As women get older, their ovarian reserve (a measure of ovaries’ ability to produce good-quality eggs) declines. Because this process of ovarian aging speeds up significantly after age 40, timely diagnosis of infertility becomes crucial especially after age 40. Every fertility treatment loses efficacy rapidly with declining ovarian reserve.
As a “fertility center of last resort” for patients with diminished ovarian reserve, CHR sees a large number of women over 40 with premature ovarian aging. Dr. Gleicher continues: “There isn’t a day when we don’t hear our patients say ‘doctor, I wish I’d known about your center years ago, when I was doing such and such…’ The earlier we can start treatment, the better, of course, our chances of helping our patients! This is why we are issuing this fertility tip sheet.”
CHR’s fertility tips for women trying to get pregnant after 40 include:
- Recognize the urgency of aggressive fertility treatment when you are above age 40.
- Insist on rapid diagnosis and a structured treatment plan.
- Insist on specific treatment goals that meet your expectations. For example, do not agree to treatment with clomiphene citrate and intrauterine insemination (IUI) if the expected pregnancy chance sounds ridiculously low.
- Do not agree to endless testing to “wait for the right results” – time is not on your side, and results will only get worse!
- It never hurts to get a second opinion.
About Center for Human Reproduction
Center for Human Reproduction, or CHR (http://www.centerforhumanreprod.com), is a leading fertility center in the United States with a worldwide reputation as a “fertility center of last resort,” specializing in treatment of infertility in women with diminished ovarian reserve, including younger women with premature ovarian aging (POA) and older women with physiological ovarian aging. Dr. Gleicher is available for additional comments.
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In the US there is a growing trend towards delayed family planning due to financial constraints, career pathways, or other personal factors. For this reason women getting pregnant at 45 for the first time is becoming more and more common and represents the fastest growing group seeking infertility treatment.
However, getting pregnant at 45 is not exactly as easy as sounds. Naturally a woman’s reproductive cycle begins to decline as she ages, with even sharper declines after the age of 35. By the time a woman reaches the age of 40 or 45, she more than likely has a diminished ovarian reserve available for reproduction.
For this reason fertility experts recommend that women over the age of 40 seek medical advice when trying to become pregnant and insist upon aggressive treatment should she not become pregnant right away.
“It’s not that every woman needs fertility treatment to get pregnant once she hits age 40,” explains Dr. Gleicher, Medical Director of the Center for Human Reproduction (CHR), a New York-based fertility center in a statement released today. However, he continues “because [the] process of ovarian aging speeds up significantly after age 40, timely diagnosis of infertility becomes crucial. Every fertility treatment loses efficacy rapidly with declining ovarian reserve.”
Treatment Options for Getting Pregnant at 45
The type of treatment recommended greatly varies on the woman’s ovarian reserve at the time of diagnosis. If a woman is determined to have a complete ovarian failure, then the use of a donor egg with an IVF cycle would be recommended. However, if a women is diagnosed with diminished ovarian reserve – which means there are still some eggs available for reproductive use – then DHEA treatment may be recommended.
DHEA and Fertility for Older Women
DHEA and fertility are a relatively new discovery in the reproductive field of medicine. Researchers have found that women with diminished ovarian reserves who take a supervised course of DHEA supplements have improved chances of becoming pregnant due to improved egg quantities and egg qualities. There is also literature to suggest that DHEA reduces spontaneous pregnancy rates, the time it takes to get pregnant, miscarriage, and chromosomal abnormalities of the developing baby.
If you are considering getting pregnant at 45, it is important that you talk with your doctor right away about the treatment options available to you.
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In the United States pregnancy in older women is becoming progressively more common. For a number of years, US national birth data has demonstrated that women above age 40 now represent the most rapidly growing age group having children.
Different societal developments contribute to this development. More women are in the work force, there are fewer and later marriages, higher divorce rates and, of course, medical progress has allowed older women conceive into their 50s either with their own eggs or via egg donation.
Norbert Gleicher, MD and Medical Director of New York City’s Center for Human Reproduction (CHR) – a leading clinical and research center in infertility – has recently brought attention to the rising number of older women becoming mothers. In a blog published by CHR he notes that a number of media reports recently presented the pros and cons of pregnancy in older women. All reports, however, missed the most important conclusion to this seemingly sudden societal development (which in reality has been growing quietly for over a decade): the developed world is in the midst of a reproductive social revolution in which we will increasingly see older, and often single, women becoming mothers.
So far, the medical profession, academia and government have failed to address potential societal consequences of an increase in older mothers. The public and medical establishments are similarly skeptical and to a degree hostile to what some have derisively called “grandmothers having children.” Yet, Dr. Gleicher notes, “The trend [of pregnancy in older women] is irreversible, and can only be expected to accelerate.”
Dr. Gleicher further points out that at CHR the median patient age, which a decade ago was around 35 years, passed 40 in 2011. Egg donation, mostly utilized by older women who no longer have use of their own eggs, is CHR’s most rapidly growing in vitro fertilization (IVF) program. Trends also can be seen nationally based on Center for Disease Control and Prevention data. Between 2004 and 2008 percentages of IVF cycles as a proportion of all IVF more than doubled above the age of 42. By 2008, egg donation cycles already represented 12.3% of all IVF cycles in the US.
“Medicine is not ready to manage pregnancy in older women safely and society is not ready to help them cope with older motherhood,” warns Dr. Gleicher. “Affected medical specialties have to develop the necessary expertise, whether they agree with patients’ decisions to be pregnant at advanced ages or not.” Feeling strongly about the subject, he concludes, “As we do not withhold care from smokers with lung cancer or from overly obese diabetics, it would be unethical to withhold care from older women desirous of motherhood.”
Center for Human Reproduction (http://www.centerforhumanreprod.com) is a leading infertility center in New York City treating patients worldwide. CHR is well-recognized for its major clinical research program, which has contributed a number of essential breakthroughs to the IVF process. Dr. Gleicher is available for further comments.
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