A Second Chance

Age – it is an important factor impacting fertility for both women and men alike. In general, the chances for parenthood are higher for women younger than 35 and men younger than 40, as compared to older women and men.

Why? Well, simply because younger women have a higher number of healthier eggs than older women. A woman is born with all the eggs she will ever have. Her eggs age with her, naturally decreasing in quality and quantity. Meanwhile, younger men produce healthier sperm compared to older men, a natural effect of aging as well. Therefore, the chances of successful conception and pregnancy decrease with age.

My patient, Madam P, we shall call her, was 33 years old when she first conceived naturally without any problems. Her first child was born a healthy baby. Madam P and her husband desired to have a second child as well.

Couples can have many valid reasons for delaying having children: career, finances, housing, travel, or even not feeling ready. As for Madam P and her husband, they had decided to postpone their plans for a second child to pursue career aspirations. When Madam P had turned 40, the couple decided it was time.

Madam P and her husband underwent in vitro fertilisation (IVF) after being unable to conceive naturally. It is offered as a primary treatment for infertility in women over the age of 40. In short, IVF consists of a set of procedures to overcome fertility issues and assist with the conception of a child. It is the most effective form of assisted reproduction.

During IVF, ovulation is induced to stimulate the growth of eggs, whereby the patient’s mature eggs are retrieved from her ovaries and fertilised by the partner’s or donor’s sperm externally, in a medical laboratory, hence the term ‘in vitro’ (a process taking place outside the living organism). Then the fertilised egg (or eggs), now known as an embryo (or embryos), are transferred to the patient’s uterus. This completes one full cycle of IVF, which usually takes about three weeks. However, it should be noted that these steps may be divided into different parts, and thus may take longer to complete.

My patient and her husband had went through numerous treatment cycles at various fertility centers before coming in to see me. Upon consultation, we proceeded with IVF, along with preimplantation genetic testing (PGT) as well as endometrial receptivity analysis (ERA). After two IVF cycles, Madam P successfully conceived.

PGT is a technique used to identify any genetic defects in embryos created through IVF before implantation in the patient’s uterus. This allows for a healthy embryo to be selected for implantation, increasing the chances of pregnancy and having a healthy baby. The test is also recommended for couples with genetic disorders, to eliminate any chances of passing them on to their child as well as reduce risk the risk to the baby’s health.

ERA, on the other hand, is a novel genetic test where an endometrial biopsy, or a small sample of a patient’s endometrial lining, is taken to determine the best day to transfer the embryo during an IVF cycle. Typically, ERA can be very helpful in enhancing chances for pregnancy (success rates may increase up to 85%) as missing the window of implantation – the period during which the uterus is most receptive to embryo implantation for pregnancy to begin – may be a cause of unsuccessful embryo transfers following IVF for patients who have been through multiple cycles.

The success rate of IVF depends broadly on the quality as well as quantity of a patient’s eggs as well as partner or donor sperm. IVF cannot resolve for the natural decline in fertility that occurs as women and men get older. Madam P’s (and her husband’s) success story was not one of overcoming her age factor to become pregnant, but that her age still allowed her to become pregnant with her second child through assisted reproduction. She had, in truth, been given a second chance through IVF.

Beyond age considerations, IVF may be able to help people with particular conditions overcome infertility, such as:  

  • Fallopian tube damage or blockage
  • Ovulation disorders
  • Endometriosis
  • Uterine fibroids
  • Previous tubal sterilization or removal
  • Unexplained infertility

You are sure to have many questions. In addressing infertility, the sooner you have them answered, the better. Do list them down and call +6-03-80699333 (TMC Fertility & Women’s Specialist Centre, Puchong) or +6-03-62871000 (Thomson Hospital, Kota Damansara) or email ask@drnavdeepfertility.com to make an appointment to consult with Dr. Navdeep.