Advances in reproductive technologies have enabled us to optimise the chances of success for patients in their 40s. We know that as maternal age increases so does the abnormalities identified within the embryos which explains the reduction in pregnancy rate and increase incidence of miscarriage.
Genetic analysis of the embryos, known as pre-implantation genetic testing for aneuploidy (PGT-A) can help us to identify the genetically normal embryos which are most likely to give you a better chance of a pregnancy.
There are options such as this which we use to help you have a successful pregnancy.
How can we help?
If you are over 40 and would like to understand more about your own fertility, the first step would be to arrange a consultation to meet with one of our Aria consultants.
At this first visit you will have a consultation with one of our medical consultants who will review your general health, medical history, including any relevant gynaecological details and discuss any previous test results, pregnancies or fertility treatment cycles.
You may be required to have a pelvic ultrasound scan to assess the reproductive health of the womb and ovaries. An antral follicle count performed during the scan, coupled with an Anti-Müllerian Hormone (AMH) blood test, will give an indication of your ovarian reserve or reproductive potential. If you have a partner then it is very important that they also attend this initial visit
During the consultation the doctor may make some recommendations regarding any further tests which are relevant based on the information you have provided about your medical history. Once we have a clear understanding of your reproductive health, we will be able to advise you on the most appropriate treatment options, whether using your own eggs or those provided from an egg donor.
The treatment planning stage.
We will discuss your personalised treatment plan and provide you with all information you need to start your treatment. Together with one of our experienced fertility nurses we will plan and provide you with a clear explanation of the treatment process. You will be guided through information about your treatment, learn how to perform you own medication injections and complete all necessary consent forms before starting the treatment cycle.
Your Treatment Options.
There are two approaches to attempting to get pregnant when you are in your 40s.
- Embryo screening (PGT-A)
- Egg donation
IVF treatment with PGT-A
If you choose to proceed with fertility treatment using your own eggs, it is important to understand that the chances of a successful pregnancy can be impacted by the increasing likelihood of genetic abnormalities developing within the embryos. At Aria, we recommend screening all suitable embryos which have reached the blastocyst stage of development (day 5 embryo) using pre-implantation genetic testing for aneuploidy (chromosomal errors).
Genetic screening offers the opportunity to assess the embryo before it is transferred back to the back. This technique requires us to biopsy some cells from the embryo and perform genetic analysis to identify which are most likely to develop into a healthy pregnancy.
Alternative methods of embryo selection which will offer a potentially higher chance of a pregnancy are through non-invasive approaches. Time-lapse imaging continuously monitors the development of the embryo and uses artificial intelligence, based on their developmental pattern, to identify the embryos which have the highest chance of implantation in the uterus.
More recently, embryology techniques which examine the culture environment the embryos are grown in are being used to assess the genetic health of embryos. This technique assesses DNA released by the embryo meaning that
The DNA released by the embryo into the culture media contains a complete picture of its chromosomal content, meaning the embryo biopsy process can be avoided. At Aria, we are currently evaluating this new technique alongside the more traditional PGT-A technique.
Some of these techniques are still considered experimental, without sufficient evidence to to determine if they will provide a significant improvement in the success of your treatment. For this reason these approaches may not be appropriate for every patient and their application depends on each individual situation.
Your consultant will discuss the most relevant fertility treatment with you based on your fertility tests. For example, it may be that rather than proceeding with a conventional approach to stimulation we attempt are more gentle variation using either natural stimulation or modified natural stimulation to achieve a pregnancy.
It is very important what whichever approach you decide, you have all the required information to make an informed decision about the treatment pathway which is most suitable for you.
Egg donation
Egg donation treatment is very similar to a standard approach to IVF, expect you will not be require to undergo the ovarian stimulation phase of the treatment. An egg donor may be anonymous or known to you. For example, if you have a relative or friend who is willing to donate their eggs. The egg donor will go through the stimulation process and once the eggs have been collected these will then be donated to you.
