In vitro fertilization (IVF) for women experiencing infertility in their thirties and forties will soon be more common than natural conception, according to a recently published data. This begs the question, where should we draw the line with IVF?
Women are generally leaving it until later to start trying for children, perhaps because they want to focus on their careers, perhaps because they are settling down and getting married later or perhaps because they feel there is always a quick fix solution with IVF if infertility becomes a problem and they can’t conceive naturally.
This worrying trend looks set to continue, as a report published in Reproductive BioMedicine Online suggests that in the next ten years advances in IVF will make it almost 100% effective. This means that women in their thirties and forties could routinely turn to IVF rather than trying to conceive naturally. In a society where we expect instant results, routine IVF may seem more appealing than months of trying for a baby.
What does the report say?
Gabor Vajta, an Australian veternarian, worked with experts from the European Society of Human Reproduction and Embryology to put together the report. It looks at the advances in artificial reproduction for farm animals, especially the production of cattle embryos, which is now almost 100% effective. They believe it won’t be long before this technology can be adapted for humans.
Young healthy couples now have a 1 in 4 chance of conceiving naturally each month that they are trying for a baby, and this decreases to 1 in 10 when the woman is over the age of 35. This can mean many months of trying to conceive, even for perfectly healthy couples, and the report suggests that the instant nature of IVF will be more appealing to modern society.
It suggests that some techniques which are currently used in IVF such as intra-cytoplasmic sperm injection, where a single sperm is injected straight into an egg, are already more efficient that natural conception. In the near future, the scientists predict they will be able to produce embryos with a near perfect success rate and cultivate them in computer-controlled storage facilities.
What are the risks and side effects of IVF?
What the report fails to discuss is the risks and side effects of IVF, which tend to increase with the age of the mother. Here are some of the possible complications associated with IVF:
- Reaction to drugs is common with IVF, and women may experience hot flashes, depression or irritability, headaches and restlessness.
- Ovarian hyper-stimulation syndrome occurs in a small number of women undergoing IVF. When drugs are given to stimulate egg production, too may eggs can develop, leading to pain, bloating and sickness. When severe, this condition is dangerous.
- Ectopic pregnancy risk is increased during IVF treatment, meaning that the fertilized egg is implanted outside of the womb, leading to severe pain and bleeding.
- Multiple births is one of the most common risks of IVF as multiple embryos are usually placed in the womb. This can lead to complications such as high blood pressure, diabetes, and premature or low birth weight babies. The risk of death during their first week is five times higher in twins than single babies, and nine times higher in triplets.
What are the risks for older women having IVF treatment?
In the U.S., most IVF clinics have an age limit of around 42 to 45 for women using their own eggs, and 49 or higher for women using donor eggs. In the U.K., the age limit for IVF is usually 39, although many women travel abroad for treatment in countries with less strict rules.
The risks of IVF for older women are greatly increased, and the rate of miscarriages and birth defects rises with age. Older women undergoing IVF are more likely to have a premature or low birth weight baby, and the risk of the baby dying in the period around birth is significantly increased.
Women over the age of 35 are likely to experience more pregnancy and birth complications even if they conceive naturally. These include:
- Increased risk of high blood pressure, diabetes and placenta previa
- Increased risk of still birth or miscarriage
- Increased chance of genetic defects such as Down’s Syndrome
Should IVF age limits be reassessed?
While most people will understand the pain of a couple who are physically unable to conceive naturally, is it right to let women undergo IVF treatment into their forties simply because they have left it until too late to start trying for a baby?
If we are heading in the direction of routine IVF treatment for women over 35, this reduces the need for women to have children when they are naturally fertile and will increase the side effects and risks associated with IVF and pregnancy in older women.