According to Dr K.D.Nayar, Chief consultant,
Akanksha IVF Centre, New Delhi,” who performs more than 400
IVF/ICSI cycles
annually, daily see 8-10 females who are desperate to conceive at the age of 35
or above and their number is sharply rising. Women are known to be born with a
limited quantity of eggs. They start to experience decreased fertility rates in
their late twenties & this rapidly accelerates as they reach their
thirties. As the age increases the quality & the quantity of eggs decline
affecting fertilization success, embryo quality & pregnancy rates. Ovarian
functions can decline without women even realizing it. Biology of female eggs
has not kept pace with career life span of today.
HOW OLD
IS TOO OLD?
At time of birth- 2 million eggs.
At puberty – 400,000 eggs.
At 40 years –40,000 to 50,000 and 45 years --- 5000.
Beginning in twenties eggs begin to diminish in quantity & quality.
Significant deterioration occurs after 35 years.
As a woman ages, a number of changes take place
in her reproductive system. For women, the cessation of menses (menopause) is
an obvious sign of ageing. But, it is by no means the only change. A transition
period lasts for many years before menopause and this occurs because of distinct
and dramatic decline in estrogen production. And as a women ages, the genetic
quality and quantity of their eggs and the efficiency with which their bodies
reject genetically damaged embryos both decline, leading to an increased risk
of genetic problems in the baby . This triad of declining fertility, declining
hormone levels and increasing risk for genetic problems is what most people
mean when they say “biological clock.”. According to Dr Nayar,” Only in 80% of
the cases the cause of infertility can be directly traced to husband or wife or
both the partners and in rest 20% no specific reason found after investigation
and evaluation of couple. This unexplained type of infertility is specifically
more common in females above 35 years of age.”
FEMALE BILOGICAL CLOCK:-
1)
WOMEN IN THEIR 20S
Fertility rate/month is – 20-25%
Spontaneous miscarriage rate 5-10%
Incidence of genetic abnormality i.e. Downs’s syndrome is 1 in 1200.
These younger women are physically active & should do moderate exercise in the first & third trimester, should avoid smoking alcohol, caffeine etc.
2)
WOMEN IN THEIR EARLY 30S
Fertility rate per month is 15%
Miscarriage rate – 20%
Should start prenatal vitamins.
3)
WOMEN > 35 YEARS
Fertility rate per month – 10%
Miscarriage rate – 25%
Risk of Down’s syndrome – 1 in 350
Genetic testing is recommended.
4)
WOMEN in their 40s
Sharp decline in achieving pregnancy.
Fertility rate per month is 5%, Even with IVF success rate is 10%
90% of eggs are genetically abnormal on biopsy.
Miscarriage rate is 33%
Incidence of genetic abnormalities is 1 in 38
5)
WOMEN above 45 YEARS
Pregnancy is a difficult proposition as virtually all the remaining eggs are genetically abnormal
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Miscarriage rate > 45%
Incidence of genetic abnormality – 1/12
Egg donation is the key.
Oocyte donation success rate- 80%
AGING IN MEN: In the last 30 years, there is 50% increase in men who became fathers above
the age of 35. The genetic quality of sperm does decline, leading to an
increased risk of genetic problems in offspring above and beyond any
contribution by the female .Although it’s an idea that has not yet filtered
down to the general public, we now know that men have biological clocks too.
And those clocks involve the same physiological triad experienced by women.
Male fertility and male sex hormone do decline with age. The decline in sex hormones is not as steep or as sudden as with
menopause. 1% per year decline in
testosterone level after age of 30 years is termed as “Andropause”. The
symptoms include decreased libido, erectile dysfunction, loss of muscle mass, weight
gain, declining cognitive function and associated with type II diabetes. Older men are at a higher risk of harboring a child with schizophrenia
and also risk of having children with Down’s syndrome. Hence now the features
of aging have expanded the notion of “biological clock” to include both sexes.
CHIEF CONSULTANT INFERTILITY & IVF, AKANKSHA IVF CENTRE,
MATA CHANAN DEVI HOSPITAL
www.akankshaivfcentre.com
Mob:- +91-9810398765
