New Treatments for Infertility 2

A study came out of California that was updated about five years ago. Patients were categorized based on age; less than 30, 30 to 34, 35 to 39, greater than 40, and day three FSH’s were measured on everybody. They also measured all sorts of other parameters; how high did their estradiol get; how many eggs did they get; how many of those eggs were fertilized; how many of those people had implantation and pregnancy resulting from their IVF. All of these variables were measured and what one can clearly see is that basal FSH, day three, is actually better than just age as an independent variant to measure to predict whether or not this person is going to get pregnant. This is a very useful tool. In fact, it is obviously both the variables of age and FSH that we use, but clearly, it has been shown that FSH independently will improve your ability to counsel a woman on her chances for success.

Clearly, the potential of getting pregnant is therefore reduced by about thirty to fifty percent, depending on who you read. I have outlined in my notes that at what rate decrement is as a person ages in a way that I think makes it a little bit easier and more palatable and understanding. There are of course other issues when you are counseling somebody who wants to get pregnant and who is a little bit older and that is that almost any single obstetric complication you can dream of is increased with age – diabetes, hypertension, pre-eclampsia, eclampsia, preterm delivery, preterm death, abortion – everything. Chromosomal abnormalities also have to be factored in at the time of the counseling session with the couple.

With IVF, independent of any other variable, just age, ongoing pregnancies per embryos transferred, about fifty percent at less than 30 linearly drops down to almost nothing by the time a person is over 40; there are just a handful of pregnancies. So IVF is not the answer for these patients.

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