Myth - ART can reverse the 'biological clock'
“Modern women have alarming misconceptions about their own reproductive systems and the effectiveness of assisted reproductive technologies”, warn researchers at Yale University (US).
Prof. Pasquale Patrizio, director of the Yale Fertility Center, has seen an “alarming” increase in women are coming to the fertility clinic at age 43 or older expecting that pregnancy can be achieved “instantly” using assisted reproductive technologies (ART). Prof. Patrizio and colleagues at Yale have published a report in the journal Fertility and Sterility (online), reviewing studies of when women have children and why.
“Perhaps the most troublesome factors involved in a woman's decision to delay motherhood,” found the authors, “are the misconceptions they might have about their own fertility, the risks of a pregnancy in an advanced age, and the effectiveness of ART. Some women were surprised to learn of their high-risk status, and other women rejected age as a risk factor.” The team also found a lack of knowledge among women about steps they can take early in their reproductive years to preserve the possibility of conception later in life.
"As clinicians,” says Patrizio in a press release, “we should begin educating women more aggressively… Women should be given the appropriate information about postponing fertility, obstetric risks, and the limited success of ART in advanced age to allow them to make informed decisions about when (if at all) they hope to become pregnant.”
Jean Hailes researcher Dr Karin Hammarberg, who is a spokesperson for the Your Fertility campaign, says that the concerns expressed by Patrizio et al. about US women are equally relevant in the Australian context. “In 2009, one in four women going through IVF in Australia was aged 40 years or older,” says Hammarberg. “The older the woman, the less the chance that IVF treatment is successful. Australian statistics show that while for women aged 30-34 years the chance of having a baby after one treatment cycle is 26.8% - this decreases to less than 1% for women aged over 44 years.”
The Yale team conclude that the best ART strategy available to women who want to postpone motherhood but really care about having a child with their own DNA is oocyte cryopreservation - i.e. freezing eggs as an 'insurance policy' for future fertility. Hammarberg warns that this is a costly option, and while it may improve the chance of conceiving at an older age, there is no guarantee of a successful outcome.
Wyndham et al. Fertil Steril. 2012 Mar 2. [Epub]
Your Fertility - a joint campaign by Jean Hailes, VARTA, Andrology Australia and the Robinson Institute