By: Shelagh McNally for Fibroids1
For most women, fertility reaches a peak at 24 years of age and then gradually declines until it’s almost impossible to get pregnant after 45. But for a select group of women pregnancy into middle age is neither difficult nor unusual.
| Common tests for infertility:|
A semen analysis for the patient's partner.
Evaluation of ovulation: basal body temperature charts, a midluteal serum progesterone level, a urine luteinizing hormone (LH) test using an ovulation predictor kit, or ultrasound monitoring of follicular development.
An evaluation of the patient’s fallopian tubes with a hysterosalpingogram.
Evaluation of Ovarian Reserve.
Scientists from the from Israel's Hadassah University Hospital have identified a group of women with a unique genetic profile that allows them to conceive well after the age of 45 without the aid of infertility treatments. The Haddasah study did a gene analysis of eight Ashkenazi Jewish women over the age of 45 who had conceived naturally and then compared their genetic profile with six other women in the same age group who stopped having children at age 30.
Researchers discovered that the Ashkenazi women had a distinctive gene pattern not present in other women participating in the study. The main genes found in this special pattern handled cell death and DNA repair mechanisms. “These women appear to differ from the normal population due to a unique genetic predisposition that protects them from the DNA damage and cellular aging that helps age the ovary. What we do not yet know is whether this reproductive success is linked with potential longevity,” said principal researcher Neri Lauferat while presenting the research at the 21st annual conference of the European Society of Human Reproduction and Endocrinology.
The study is also dispelling another popular theory that having a lot of children may increase the chances of future pregnancies. Dr Lauferat pointed out that if this theory was accurate then the Ashkenazi women should have a higher than usual miscarriage rate. In fact, their miscarriage rate was extremely low.
Infertility rates by age
Age 20 to 29: 10 percent
Age 30 to 39: 25 percent
Age 40 to 45: 50 percent
In the U.S. approximately 10 percent of women between the ages of 20 and 29 reported difficulty in conceiving. For women in their 30s infertility was at 25 percent and by age 40 that figure was up to more than 50 percent. The most common age-linked cause of infertility is a low number of remaining follicles in the ovary and the diminished quality of the follicles remaining. Although it may be easier for them to become pregnant, there are fewer women in their 20s having children while the number of over 30 and over 40 has increased sharply in the last two decades. According to the Center for Disease Control and Prevention, 2003 birth rates for mothers aged 20-24 increased by 4 percent as compared to a 6 percent increase for the 35-39 age group and a 5 percent increase for those 40 to 44. The birth rate for those between 45-40 remained unchanged at 0.5 percent.
| Facing infertility? Treatment options include:|
AH: Assisted Hatching
ICSI: Intracytoplasmic sperm injection
IUI: Intrauterine insemination
Evaluation of Ovarian Reserve .
IVF: In vitro fertilization
As women wait longer to have children, many are turning to infertility treatments when they have trouble conceiving. Most physicians agree that age 42 should be set as the age limit for fertility treatments. Lauferat is hopeful the discovery of these gene patterns will help doctors identify women who will still be fertile when older and determine what type of fertility counseling is needed. “However, the question of motherhood over the age of 45 is a delicate and complex one. It is very dependent on the religious and cultural background of the women in question,” he said.
According to the National Center for Health Statistics, a total of 255 American women between the ages 50 and 54 bore children in 2000. The Guinness World Records 2001 lists two 63-year-old women who have given birth: Rosanna Della Corte of Italy in 1994 and Arceli Keh of California in 1996. To date, the oldest mother on record to is 66-year-old woman from Romania who underwent fertility treatment for nine years before finally becoming pregnant.