How technology is changing pregnancy for women over 40

The New Straits Times Letter to the Editor, 28 July 2020, features Dr Navdeep’s thoughts on advancements in fertility treatment, defining infertility as a disease, and his commitment towards helping couples build a family.

LETTERS: Advancements in fertility treatments and technology are helping more and more women who are facing age-related infertility achieve their dreams of having a baby.

Developments in procedures and technologies in fertility science complemented by laboratories that adhere to the highest standards ensure the best chances of creating and growing embryos to facilitate pregnancies.

Procedures such as Preimplantation Genetic Testing (PGT) ensure that the best embryo can be selected for transfer, and Endometrial Receptivity Analysis helps doctors determine the best time to transfer the embryo.

Improvements in medication has reduced injections needed to be administered to women in preparation for In-Vitro Fertilisation (IVF) from six weeks to 10 days. These have contributed to increased success in pregnancy and decrease in miscarriages.

In fact, the success rate of pregnancy through IVF is almost 60 per cent now compared with 20 per cent previously.

Still, how is it possible that women in their 40s and above can conceive? Most age-related infertility problems in women are due to germ cell deterioration.

By the time women turn 40, their ovarian reserve or eggs are reduced markedly. However, the uterus remains functional.

Therefore, for women above 50 to conceive, an egg from a donor is artificially inseminated by the husband’s sperm to create an embryo.

The embryo is implanted in the woman’s womb, which carries the baby to term. While it is a possibility, advanced age pregnancy may not be for everyone. Ethically, fertility specialists first need to determine if the woman is healthy enough to carry a child.

For this reason, early pregnancy (preferably between 20s and 30s) is the ideal convention. If a woman is not ready to have children in her 20s or even 30s, she can ensure her chances of having a healthy embryo years later by preserving her eggs while she is young with oocyte cryopreservation or egg freezing.

However, when it comes to fertility, the fundamental message is: don’t wait until it becomes a challenge. To be exact, couples should see a fertility specialist after six to 12 months of trying but failing to conceive. Fertility is a potentially treatable problem.

The problem lies in the fact that infertility is generally not considered a medical problem. Instead, it is seen more as a social issue. Infertility may not be a life or death case but it is a long-term (chronic) condition.

People can be childless for life and this can contribute to mental and emotional health problems, marriage breakdowns and career failures.

For a long time, infertility wasn’t even considered a disease. It was only in 2009 that the World Health Organisation and the International Committee for Monitoring Assisted Reproductive Technology defined infertility as “a disease of the reproductive system”.

The right to procreation must be seen from a broader perspective. Besides its importance to the survival of mankind, children are imperative for a nation.

Dr Navdeep Singh Pannu
Fertility Specialist
Puchong, Selangor

Source :
New Straits Times
https://www.nst.com.my/opinion/letters/2020/07/612116/how-technology-changing-pregnancy-women-over-40