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Advanced Maternal Age and Egg Quality

Catherine McDiarmid-Watt | Sunday, February 21, 2016 | 0 comments

Image: Yvonne, by Duane J, on MorgueFile
A woman who is over age 43 or 44 will often be turned away from any chance at assisted reproductive technology because of the age and therefore poor state of her ovaries.

She may fail to respond as favorably to the gonadotropins as her younger counterpart, because her eggs have become less responsive to hormonal stimulation.

She may produce few numbers of eggs, whose outer capsule is tougher and thus less capable of fertilization. Those eggs which do become fertilized may have more inclusions during early embryologic development, meaning there are more waste products put out by the mitochondria. Less make it to the blastocyst stage, even fewer are capable of implantation and fewer yet make it through the full embryonic development.

That is why a woman over forty is statistically less likely to give birth, and is encouraged to find alternative ways of becoming a mother. She will be told she has poor quality eggs. Her reproductive endocrinologist will strongly suggest that she consider using a younger donor's eggs. This makes her chances of having a baby, and thus her RE's statistics, much higher.

The reason for the lower chances of assisted reproductive success in older women is because the only portion of the hormonal process that is manipulated is the last few weeks of this many months' process. Massive doses of gonadotropin hormones are given to the women in order to (hopefully) recruit more follicles. This doesn't, however, make them of better quality.

Perhaps the reason she has been unsuccessful in conceiving in the first place is because her hypothalamic-pituitary-ovarian axis has been ailing, and the reflection has been in the resistance of her ovaries, the eggs contained within, and thus the inability to conceive. It seems that the older a woman is, this process of follicular development, which takes up the better part of a year, becomes more susceptible to breakdown.

Experience has shown that if the hormonal system is in perfect working order and a woman has clockwork menstrual cycles, no matter what her age, a healthy egg can be released on time. It then has a good chance of becoming fertilized, implanting, and making it through embryologic development to become a child.

The emphasis here is on the healthy hormonal cycle. If each individual element of the hypothalamic-pituitary-ovarian axis is still in healthy inter-relationship during this process, the developing follicles are going to reflect this state of well-being.

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Photo credit: Yvonne, by Duane J, on MorgueFile
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Image: The Fertility Guide: A Couples Handbook for When You Want to Have a Baby (More Than Anything Else), by John C., II Jarrett and Deidra T. Rausch. Publisher: Health Pr (September 1998)The Fertility Guide: A Couples Handbook for When You Want to Have a Baby (More Than Anything Else)
by John C., II Jarrett and Deidra T. Rausch

-- This Fertility Guide provides a concise, sensible, appropriately scientific, but yet easily understood approach to modern fertility diagnosis and treatment.

Dr. Jarrett and Dr. Rausch have translated their vast and highly successful clinical experience into a "must" for the couple who "want to have a baby more than anything else."

The most important contribution of this book is that it translates the "high tech" into common sense and fills an important void in the specialty... -- E.P. Peterson, MD, Past President of American Society of Reproductive Medicine, Clinical Professor Dept OB/GYN University of Michigan.

Image: Buy Now on Amazon.comPaperback: 200 pages
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More "Pregnancy Over 40" blogs to visit:
Life Begins... - Pregnancy stories of loss, hope and help
Pregnancy Stories by Age - Daily blog of hope and inspiration!
You Can Get Pregnant in Your 40's - Sharing articles, discussing options and suggestions
Stories of Pregnancy and Birth over 44 - sharing news stories I find online, for inspiration!

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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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