New Study Shows Diet & Lifestyle Habits Greatly Impact Sperm Health
Fertility After Age 40 – IVF in the 40s
Page author Richard Sherbahn MD
At age 40 and above women have reduced fertility potential as compared to that seen in younger women. They also have substantially lower success rates with fertility treatments including in vitro fertilization (IVF).
There is nothing special about “40” as far as an age is concerned. However, perhaps because we have five fingers on our hands we tend to think in fives and tens. Therefore, it seems sometimes that for women the ages 35 and 40 are a big deal.
When couples are trying on their own to get pregnant the fertility issue that reduces chances for success is related to the quality of the eggs. With treatments such as IVF, the issue that holds back success potential is both egg quality and egg quantity.
Age Limits for IVF Treatments
- Most US IVF clinics have an upper age limit for allowing IVF treatment using “own eggs”of somewhere between 42 and 45 years of age.
- Donor eggs are commonly used until about age 49 – some programs will still do it after age 50
How Does Egg Quality Affect Fertility and IVF?
The quality of the egg is the most critical factor involved in determining the quality of the embryo. With IVF treatment we hope to get multiple embryos so we can choose the best ones from a group for transfer back to the uterus.
A big part of the “egg quality” equation involves the chromosomal status of the egg. The rate of chromosomal abnormalities in eggs (and therefore also in embryos) increases significantly with advancing female age. At age 30 about 30% of eggs are chromosomally abnormal. By age 40 about 60% are abnormal and by 44 years old 90% are abnormal.
Preimplantation genetic screening (PGS) can be used to test embryos for chromosomally normalcy (euploidy) prior to transferring them to the uterus. Embryos that have normal chromosomal analysis after PGS have a very high potential for implantation and live birth.
How Does Egg Quantity Affect Fertility and IVF Success Rates?
The quantity of eggs remaining in a woman’s ovaries is often referred to as “ovarian reserve”.
More about tests of ovarian reserve
The quantity of remaining eggs probably does not have a large impact on natural fertility (trying to get pregnant “naturally”). However, when going through a fertility treatment such as IVF, the quantity of eggs remaining influences response to ovarian stimulating medications.
- More eggs remaining means more eggs retrieved with the in vitro cycle
- More eggs to work with in an IVF cycle gives a higher chance for successful pregnancy
- More about the number of eggs with IVF and success rates
In Vitro Fertilization Success Rate Statistics by Female Age – and After Age 40
- The charts below illustrate the rate of live births per embryo transfer procedure by the age of the recipient of the embryos.
- The data shows the impact of advancing female age on IVF success.
- Although these age and fertility statistics are specifically about IVF success, there is a similar loss in fertility potential with aging in the general “normal fertile” population.
The graphs below are from the 2013 ART Success Rates report published by the CDC, Centers for Disease Control and Prevention, a US government agency. This report was generated from national data from 467 clinics and over 190,000 IVF cycles.
The green line shows IVF success rates using the infertile woman’s own eggs
The blue line shows success rates using donor eggs
The graph above illustrates infertility increasing with advancing female age.
- The decline in live birth success rates by female age beginning at about age 30
- This curve becomes steeper (egg quantity and egg quality decreases faster) starting at about age 38
- At age 44 and above there are almost never babies born from IVF using a woman’s own eggs
- The success rate using eggs over age 44 is about 2% per attempt.
Another point shown here is that there not a substantial decline in success by age of the recipient woman with donor egg IVF.
- The age of the eggs is very important
- The age of the uterus carrying the embryos is not important
In Vitro Fertilization Success Statistics from the CDC for Age 40 and Over
Circled in red on this graph for USA national average 2013 IVF live birth rates
Under age 35: Live birth rate per cycle of 40%
Age 41 to 42: Live birth rate of 11%
Age 43 to 44: Live birth rate of 5%
This graph from the CDC zooms in on national average IVF statistics for women over age 40 for 2013
The IVF live birth percentage rate per cycle for each age is circled in red
Age 40: Live birth rate of 17%
Age 43: Live birth rate of 6%
Age over 44: Live birth rate of 2%
- The national summary (as well as clinic specific results) of IVF success rates for cycles done in years 1995 through 2014 are posted on the CDC website.
- Check your fertility doctor’s IVF success rates
- See our IVF success rates
- See our egg donation success rates
- What to do if the first IVF cycle fails
All clinics have some upper age limit after which they will not perform in vitro fertilization with the woman’s own eggs.
IVF age limits are not the same at every program
- The age limit is usually between 42 and 45 at most programs in the US
- Our age limit for IVF using own eggs is 45 (no IVF with own eggs after the 46th birthday)
- Most IVF clinics allow a woman to be a recipient of donor eggs through about age 50
A dark, low quality egg with an irregular shape from a 41 year old The egg is the ovoid structure in the center surrounded by hundreds of ovarian cumulus cells
Diet plays such an important role in health that it has always been my first question and answer when clients ask me how to heal this, or help with that. When it comes to fertility and pregnancy it is of the utmost importance to eat a healthy whole food diet. Everything you eat and drink has an impact on your health and the health of your baby. Pre-conception nutrition is important not only to make sure you are prepared for a healthy pregnancy, but to also avoid many fertility issues. Here are some of my top tips on eating a healthy fertility diet…
- Eat as many raw fruits and vegetables a day as you can – at least 5 servings of veggies and 3-4 servings of fruit. General serving size is one small peach or 1/2C of veggies. Here are some ideas to get enough fruits and veggies into your diet daily:
- Eat fruits as snacks in between meals
- Eat a large salad as one of your meals
- Make sure 50% of your plate is veggies
- Eat a dark leafy green with dinner
- Drink fertility smoothies
- Drink fresh vegetable juices daily
- If you eat animal protein focus more on cold water fish instead of beef or chicken. Fish are abundant in omega 3 fatty acids which are essential in a fertility and pregnancy diet. If you are vegetarian in addition to eating beans and lentils daily add some nuts to get Omega 3 daily.
- Eat 1 heaping teaspoon of ground seed or 1T of seed oil (such as hemp or flax) a day. This will assure that you are eating some essential fatty acids every day. Seeds high in Omega 3 are: flax, hemp, pumpkin, walnut. Seeds high in Omega 6 are: sunflower and sesame.
- Eat 3-4 serving of WHOLE grains a day. Quinoa, millet, oats and rice are some of my favorites. Amongst many things, whole grains supply B vitamins and fiber which are both essential for a healthy fertility and pregnancy diet. Try to mix it up and eat a wide variety of while grains and avoid processed grains.
- Drink 8 glasses of clean water a day (reverse osmosis or spring water being the best). Avoid bottled water as the plastics leach estrogen-mimicking chemicals into the water). One tip is to start the day with a quart of water with lemon in it and drink as much as you can upon rising and finish the rest in the next half an hour. That will take care of half of your water for the day and help the body to gently cleanse itself in the morning.
- Avoid food that is burnt, fried, browned, has hydrogenated oils, saturated animal fats and microwaved foods. These types of cooking and ingredients can cause the body to create free radicals which can negatively affect cell DNA. The key to healthy ova (egg) and sperm is intact DNA. If the DNA has been impaired by free radical damage is one cause of miscarriages, blight ovum and inability to get pregnant.
- Avoid sugar and sweeteners in all forms – white sugar, high fructose corn syrup, etc. Sugar negatively effects the blood sugar levels which can effect hormonal balance and ovulation. A great alternative is stevia.
- Avoid alcohol on a daily basis and keep the coffee down to one cup or even better quit all together..
- Take a whole food multivitamin DAILY. When trying to conceive or in preparation it is best to use a whole food prenatal multivitamin that contains folic acid, iron, zinc, b12, and vitamin C… nutrients that are necessary for a healthy pregnancy before you are even pregnant ( eg DS 24).
- Drink a fresh juice or make a smoothie daily. Juices and smoothies are a great way to get a huge amount of nutrients in an easy to assimilate form.