Infertility Treatment Options for Women Over 40

If you weren’t really ready to start a family way back when you were in your 20s, you’re not alone. Pursuing a higher education, advancing your career, traveling the world, building a home, and finding the right person to share your life with takes time, and many women today find themselves trying to conceive for the first time when they’re in their late 30s or early 40s.

You may be worried about your chances of conceiving naturally if you’ve heard that being past the age of 35 can simply make it harder to become pregnant, or that being past the age of 40 means you may not be able to conceive without some type of reproductive assistance.

While it’s true that the average 40-year-old woman has far fewer high-quality eggs than she did in her 20s, your personal chances of conceiving depend on a variety of factors, not just the number of candles on your last birthday cake.  

Here at California Center for Reproductive Health, we take an urgent and individualized treatment approach for women over 40 who’ve had trouble conceiving naturally. Here are some of our most successful strategies.

Infertility evaluation

It’s impossible to begin an individualized fertility treatment protocol without first undergoing a preliminary infertility evaluation. For women over 40, infertility is generally defined as the inability to become pregnant after six months of regular, unprotected sexual intercourse.

In many cases, a comprehensive infertility evaluation can be completed within one or two menstrual cycles. The evaluation process requires a detailed medical history and physical exam, including a variety of lab tests and imaging tests. Depending on your unique case, you may undergo hormone testing, ovulation testing, or pelvic ultrasounds to pinpoint or rule out certain conditions or structural issues.

Lifestyle changes

When you’re in your 20s, it’s fairly easy to lead a relatively unhealthy lifestyle and still become pregnant. But once you hit your mid-30s and beyond, making consistently healthy lifestyle choices is key to protecting and promoting fertility.  

As the quantity and quality of your eggs decline, it’s increasingly important to double down on healthy habits to ensure you’ve done everything you can to support your body’s reproductive system. Eating a nutritious diet, staying moderately active most days of the week, quitting smoking, and avoiding alcohol are several important steps you can take toward optimal fertility.

Another key change you may need to make is achieving a healthy body weight. Being overweight or significantly underweight can make it more difficult to become pregnant because both conditions can impact your estrogen levels and interrupt normal ovulation, which is the monthly release of an egg from one of your ovaries.

Many women in their late 30s and early 40s are surprised to learn that reaching a healthier body weight is sometimes all it takes to reestablish normal ovulation and make pregnancy possible.

In vitro fertilization (IVF)

Although healthy lifestyle changes are an important piece of the fertility puzzle, these changes aren’t always enough to complete the picture. In such cases, in vitro fertilization (IVF) with ovarian stimulation is often one of the quickest and most reliable treatment options for women over 40.

During IVF, your ovaries are stimulated with injectable fertility medications so they produce multiple eggs, which are then surgically removed and fertilized in a lab with your partner’s sperm or donor sperm. The fertilized egg grows in a strictly controlled environment for up to five days before it’s transferred to your uterus, where it’s meant to implant itself in your uterine lining and continue to develop.   

Although IVF success rates for women using their own eggs begin to decline rapidly starting at about the age of 38, a significant number of women over the age of 40 — and up to about the age of 44 — have experienced IVF success using their own eggs.

At the California Center for Reproductive Health, our IVF success rates for women ages 41-42 is about one-and-a-half times better than the national average. For women over 42, our IVF success rate is about four times better than the national average.  

Egg donation considerations

As you get older, it’s important to keep in mind that the age of your uterus is far less important than the age of your eggs, simply because egg quality declines rapidly once you’re over 38. That’s why if you’re over the age of 40 and haven’t had success with IVF using your own eggs, you may want to consider using donor eggs to help make your family dreams a reality.

Although many women view using donated eggs as a sort of last-resort treatment, it’s an ideal option from the standpoint that it offers a much higher success rate than IVF treatments using older eggs.

In fact, IVF done via egg donation results in higher success rates than many other types of assisted reproductive technology, making it a wonderful alternative for women who don’t have success with other treatment methods, including IVF with their own eggs.

If you’re over 40 and you’re ready to make your family dreams a reality, call one of our clinics in Encino, West Hollywood, Monica, or Valencia, California, or use the convenient online tool to schedule a fertility consultation today.

If you and your partner have struggled to conceive naturally, you know how disheartening and emotionally exhausting infertility can be. Making the decision to undergo in vitro fertilization (IVF) can give you the optimism and boost of confidence you need to continue trying for a baby — provided you understand what to expect along the way.

Here at California Center for Reproductive Health, we’ve helped countless couples fulfill their family dreams with IVF, and we know that a little information can go a long way in making the IVF process more comfortable and manageable. With that in mind, here are some of the answers to questions we hear all the time from the couples we treat at our Los Angeles-area clinics.  

How does IVF work?

IVF, the most common form of assisted reproductive technology (ART), is used to bypass a wide range of fertility problems, including low sperm counts and irregular ovulation.

During IVF, a woman’s eggs are surgically removed and fertilized in a laboratory with either her partner’s sperm or donor sperm. Once the egg is fertilized, the pre-embryo is left to grow for up to five days before it’s transferred to the uterus, where it hopefully implants itself in the uterine lining and continues to develop.   

IVF can be done using a woman’s own eggs and her partner’s sperm, or it can be done using sperm or eggs from a donor. IVF can also be done using a surrogate to carry the pregnancy to term.  

Am I a good candidate for IVF?

If you and your partner have been actively trying to conceive for a year (or six months if you’re past the age of 35), you may be a good candidate for IVF. The only way to know for sure is by having a comprehensive physical exam to determine the underlying cause of your fertility issue.  

IVF has helped women with polycystic ovary syndrome (PCOS), endometriosis, and other physical or hormonal problems; it’s also successfully helped men with low sperm counts or mild sperm abnormalities, as well as women who suffer recurrent miscarriages.

How long does IVF take?

A single IVF cycle includes having fertility hormone injections to stimulate egg production for 8-10 days, followed by the egg retrieval procedure and in-lab egg fertilization. In the lab, the pre-embryo is monitored for quality for 2-5 days before it’s transferred to your uterus. Two weeks after the transfer procedure, you’ll have your first pregnancy test to find out if things are progressing as hoped.

If the first test shows that you’re pregnant, you’ll continue having early blood tests to monitor your progression until an ultrasound can verify a heartbeat, which usually happens 8-10 weeks into pregnancy.

If you’re not pregnant, you can expect to wait one or two full menstrual cycles before going through your next round of IVF treatment. Although some women become pregnant after the first IVF attempt, many women undergo multiple IVF treatments before successfully becoming pregnant.  

Are there any restrictions during IVF treatment?

To increase your chances of treatment success, it’s important to follow all basic IVF guidelines and recommendations. This includes quitting smoking at least three months before you begin your first IVF cycle; if your partner smokes, he should quit as well. You should also avoid drinking alcohol or taking herbal supplements of any kind from the outset of IVF treatment.  

While you can still partake in low-impact exercises like walking, you should avoid high-impact or vigorous exercise during treatment. After a pre-embryo transfer, you should also refrain from sex until you’re given the go-ahead to resume normal sexual activity.

Does IVF treatment have any side effects?

Medications used to increase fertility can cause a variety of side effects, including headaches, mood swings, breast tenderness, mild cramping or bloating, and constipation.

At California Center for Reproductive Health, we’re proud to offer mini IVF, a gentler alternative to traditional IVF ovarian stimulation that uses lower doses of hormones with great success and with fewer unwanted side effects. Mini IVF is also less expensive than traditional IVF.

Does IVF make multiples more likely?

If you’re only having one pre-embryo transferred to your womb each IVF cycle, then having twins or multiples isn’t a possibility.

If, like many women, you choose to transfer multiple embryos to your uterus to help increase your chances of becoming pregnant, there’s always the possibility that more than one of those embryos will implant and develop.  

Interestingly, women who opt for multiple transfers aren’t significantly more likely to become pregnant than those who opt for a single transfer; if they do become pregnant, however, they’re more likely to wind up with twins or triplets.

How successful is IVF?

Your own chances of IVF success depend on your age, infertility diagnosis, reproductive history, and overall health.

In general, IVF success rates for women using their own eggs begin to decline at the age of 30; then, starting at the age of 35, they decline rapidly. Using donor eggs can improve your chances of IVF success if you’re older than 35.

At California Center for Reproductive Health, our IVF success rates — meaning IVF treatment that results in a live birth — consistently beat the national average.

To find out how we can help make your family dreams a reality, call today or schedule an appointment online. We’re ready to answer all of your IVF questions.

Many couples turn to in-vitro fertilization (IVF) treatment after years of trying to conceive naturally. As the most common form of assisted reproductive technology, IVF also is the go-to conception method for many single women or same-sex couples who want to start a family.  

Although IVF has a relatively high success rate, the process itself isn’t always quick or easy. Here at California Center for Reproductive Health, we’ve helped countless families in the Los Angeles area become pregnant through IVF, so we understand the unique emotional and physical challenges that IVF patients face.

If IVF treatment has left you feeling anxious or frazzled, these strategies can help you manage your stress and stay calm each step of the way.  

Learn everything you can about IVF

IVF is a multi-step process that’s carefully planned and carried out within your monthly cycle.

Learning everything you can about each step of that process — the medication you take to boost egg production, the egg retrieval procedure, artificial insemination, embryo cultivation, and finally, embryo implantation — can help normalize your expectations and make the overall process less stressful.

Even if you’re well-informed as you head into the process, don’t be afraid to voice any questions or concerns you may have; your fertility team does whatever they can to alleviate your doubts and ease your anxiety.

Make daily self-care a priority

You already know that taking care of yourself boosts your odds of becoming pregnant and having a healthy baby, but good self-care goes beyond the basics of avoiding alcohol and quitting smoking.

You should make exercise a priority because it increases your strength and endurance, and because it helps you stay energized — even on days that are emotionally draining. Exercise also stimulates the release of endorphins, which can help you maintain a positive outlook. Good options include brisk walking, swimming, and yoga (but not hot yoga).

Getting regular exercise actually can help you sleep better at night, which is another major self-care priority when you’re going through IVF treatment. To minimize anxiety and give yourself the best chance for IVF success, it’s important to protect your bedtime and get the rest you need each and every night.

Embrace instant stress management techniques

When you’re going through something that’s as stressful as IVF treatment can be, it’s beneficial to discover and embrace a few stress management techniques that can instantly take the edge off and help you relax.

Simply learning how to press pause when feeling anxious or experiencing stress-inducing thoughts is a good way to start. Once you’re ready to take charge of your thoughts and feelings, taking deep, calming breaths can help slow you down so you can find your center once again.

While sitting or lying comfortably with one hand on your diaphragm, inhale evenly, slowly, and fully for a full count of four. Hold your breath for a count of one before you exhale for a count of four, using the same type of control.

In addition to alleviating stress and anxiety instantaneously, deep breathing also can help you find a more complete connection to your own body and the process it’s going through.   

Face your fear of failure

For many patients going through IVF treatment, the thought that it may not be successful is both realistic and a major cause of stress. This is only natural, of course, especially for couples who have struggled with infertility — IVF represents a real chance for the family they’ve dreamed of for years.

IVF does have a high rate of success because it bypasses many of the biological processes that lead to natural pregnancy, but worrying about whether or not you’ll become pregnant each IVF cycle won’t help you reach your goal.

In fact, a small 2010 study published in the Journal of Assisted Reproduction and Genetics found that women who are stressed or worried while undergoing IVF treatment were less likely to become pregnant than women who successfully managed their stress and anxiety.

Instead, try reframing your fear by viewing failure as another step on your journey toward the pregnancy you’re trying for. An unsuccessful IVF cycle allows your fertility team to better perfect your treatment protocol, ultimately increasing your chances of success.

And in the meantime, keep practicing good self-care and stress management techniques.  

Don’t go it alone

Going through IVF can make you feel isolated, especially when it seems like no one else in your circle of friends and family has struggled with fertility. Infertility actually is a common problem, however, and it’s important to allow others to support you in your IVF experience so that you don’t end up feeling like you’re alone.  

Lay the groundwork for honest and open communication with your partner if you have one, and seek out supportive family members and friends you can rely on. To minimize your stress and maximize your chances for success, give those you’re closest to a chance to understand how you’re feeling, to support you emotionally, and to help you through the experience.  

If you aren’t sure you want to lean on your partner, family, or friends, you may be able to get the same benefit from a counselor, therapist, or IVF support group.

While infertility is a physical condition, there are mental and emotional health issues that are often linked to it. Sources of stress include the need for injections, the financial toll, negative pregnancy readings, and the social stresses of holidays and baby showers.

Because of all these various factors, handling the stress of infertility is certainly not easy, but the path is made a bit more manageable by advice on the topic provided by associations and experts. Here are 7 of the most common strategies that are recommended in order to cope with infertility and process related stresses in a healthy manner:

1.) Collect information.

It is good to learn about a healthy and normal infertility response. One way to stop feeling negative about your perspective while you are working with a fertility clinic is to see how other people have felt vulnerable in the same situation.

2.) Let yourself grieve.

While you want to end with a successful pregnancy, it is difficult not to start to go through grieving for a child that does not yet exist. When you have grief that is sustained and that cannot reach a resolution, you may start to feel anxious. Grieving the child that you have not had is all right. Parents Magazine calls this “grieving a dream.” There are various ways to approach this mourning process. You can speak with a good friend or with your partner. You can write your responses. Whatever you do, you want to be recognizing the grief that you have and resolving it – which in turn will allow you to release it.

3.) Get physical.

Working out can help to release stress, as noted in the 6th item below. Exercise has manifold additional benefits, such as allowing the release of healthy endorphins, allowing us to cope with anything that comes our way so we can maintain better positivity.

Canadian registered psychologist Ronda Trumper advises to try low-impact options such as walking, especially if you can do it outside and get the additional benefits of spending time in a natural setting. Any exercise will help you to stay fit and keep you feeling positive as well. Some people will choose to go for runs instead. It is more common to feel energetic and want to exercise in between IVF cycles than during the cycles.

Trumper also mentions yoga as a possible exercise, as long as you do some form other than the hot variety. It is also a good idea to notify the teacher that you are trying to get pregnant – since they may have specific suggestions for how to perform poses differently or avoid some of them altogether. Be aware that your physician may tell you to stay away from certain types of workouts following transfer of the embryos and as you are waiting to learn if you are pregnant or not.

4.) Keep your loved ones in the loop.

The infertility nonprofit RESOLVE advises that you can help those around you better respond to the situation by informing them about the issue. You could suggest a reading for them to get a basic sense of the challenges surrounding infertility. Plus, you could benefit from letting those around you know specifically how you want them to treat you related to this part of your life.

5.) Practice your breathing.

You will naturally be able to bring down your stress level simply by learning to breathe deeply. You can go through a series of deep breaths either with your partner or by yourself. To start with deep breathing, sit in a comfortable position, and close your eyes. Start inhaling gradually and deeply. Inhale through your nostrils, and exhale through your mouth. You want your diaphragm and chest to both feel filled with air. This practice should be conducted slowly and mindfully. When you feel stress, simply use deep-breathing exercises for 5 minutes to get some relief.

6.) Allow yourself to feel emotional.

It is not always wrong or inappropriate to get angry or to feel terribly sad. Suppressing your true emotional response can be very unhealthy. Crying when you feel frustrated about not being able to achieve a pregnancy is something that you should feel comfortable doing. Taking out angry energy with a punching bag or other high-intensity workout can help in dealing with that emotion.

7.) Talk to your partner.

Your partner will not be able to figure out how to support you properly if you do not let them know what you need. If you are feeling down and want to stay home from an event, that should not be a problem but should be supported. It is up to you to say something. Let your partner know if you want to have additional alone time, or if you just could use a hug.

Compassionate help for infertility

Are you feeling high stress related to infertility? At California Center for Reproductive Health, we want you to feel calm and to ultimately be successful. Our patient Stacey B. said that Dr. Mor “was informative, compassionate and truly dove into my case keeping my wishes first.” See our testimonials and reviews.

It’s a pretty safe bet that in every aspect of life, the thing people desire the most is certainty. Sure, there are exceptions to this rule, but more often than not people want to know that they’re making a safe decision or that there will be a positive outcome to the action they are taking. That’s pretty abstract, so let’s talk about certainty in regards to starting a family. Every parent to be wants as much certainty as possible that their future child will be as healthy as possible with no foreseeable complications. While no one is born perfectly healthy with no genetic risk factors for conditions later in life, parents want to know what they can expect.

Every couple can relate to this, though it’s perhaps even more true of parents who are experiencing fertility issues and are considering trying in vitro fertilization in order to conceive. In vitro fertilization is the most commonly used procedure in order to circumvent fertility issues. While the 30-40% success rate is on par with the chances of getting pregnant naturally during any given cycle, there is still that additional element of uncertainty. After all this, will the baby be healthy? Will special care be required?

These questions can be anxiety inducing. That’s why many couples that are considering trying IVF in order to conceive opt for preimplantation genetic screening (PGS) and preimplantation genetic diagnosis (PGD). They are similar in concept to a prenatal diagnosis. These tests can tell you many things about the embryo created via IVF prior to embryo transfer. Here is what you can learn from PGS and PGD.

What is PGS?

PGS is a laboratory technique that allows for chromosomal analysis of the embryo before it is transferred to the womb to carry out the pregnancy. Chromosomes can tell a lot about the viability of the pregnancy. If the number of chromosomes differs from the usual 46, aneuploidy occurs. One way aneuploidy can manifest is in a child born with Down’s syndrome due to the extra chromosome. Aneuploidy can also result in a miscarriage, which is a significant risk factor for older women. By undergoing a PGS before embryo implantation, it can be determined if there is a chromosomal abnormality. If that is the case, the embryo won’t be transferred and a new fertility treatment course can begin without delay. If a miscarriage occurs, not only is this emotionally devastating, but it can also be a significant setback for starting a new fertility treatment. Generally, it takes several months following a miscarriage to be able to try fertility treatments again.

How does PGD differ?

PGD is a deeper analysis that goes beyond chromosomes to provide a genetic analysis before an embryo is transferred. PGD can test for autosomal recessive disorders and autosomal dominant disorders. Recessive disorders, like cystic fibrosis, don’t manifest in the parent, but they carry the genes for the disease. Dominant disorders, like Huntington’s Chorea, typically afflict one of the parents, which makes passing on the disorder even more likely than in the recessive scenario. Sex-linked disorders attached to the X or Y chromosome can also be identified. Essentially, PGD works to identify embryos that are at high risk for inheriting a disorder and identifying embryos that are unaffected.

Who should opt for PGS and PGD?

Anyone is a good candidate, but if you or your partner have any genetic risk factors that you are aware of, testing is strongly recommended. Even if the two of you don’t necessarily have any conditions that you’re aware of, someone in your family may. For example, having a close relative with Down’s syndrome or cystic fibrosis can increase the chances of you genetically passing that on to your child.

Additionally, PGS may be recommended for reasons beyond checking for genetic conditions in the embryo. If you’ve already suffered multiple miscarriages, PGS may be able to shed light on the reasons why and to decrease the chances of it occurring again. PGS can also address issues relating to infertility.

Conclusion

While absolute certainty is hard to come by, gathering enough facts and risk factors can give you the insight you desire regarding your baby. While many different genetic conditions can be identified with PGS/PGD, you can also find out if the embryo being tested is viable for a successful pregnancy. If you already know that you or your partner have risk factors that may be passed onto your child, it’s recommended that you opt for this testing. If you have any questions about fertility services or testing, or you’re ready to get the process started, book an appointment online to schedule a consultation today. Dr. Mor and the team at California Center for Reproductive Health are here to provide the care and fertility services needed so you can start the happy, healthy family you’ve always wanted.