Burning Questions

"Can I Get Pregnant With IVF With My Own Frozen Eggs or Embryos in My 40s or 50s?"

5 mins read

Introduction

As women increasingly delay childbearing to pursue career goals, education, or to find the right partner, the utilization of assisted reproductive technologies (ART) like egg freezing and embryo freezing has become a prevalent option. However, many women who aren't ready to start a family now wonder about how likely they are to get pregnant and give birth to a healthy baby at a later time with frozen eggs or embryos. The questions often asked are: What's the success rate of giving birth to a healthy baby after 5, 10, or more years of freezing eggs? How good are my chances of getting pregnant when I'm in my 40s or 50s? Is it worth it to freeze my eggs for a later pregnancy?

Since freezing eggs or embryos takes out the issue of the natural decline of ovarian reserve, the question about reproductive health remains about the uterus' ability to take or accept the transfer and factors influencing pregnancy and childbirth. In this article, we try to break down some of those questions, provide answers with information currently available, and explore things to do to improve your chances.

Using frozen eggs or embryos at a later date

With frozen eggs, there's still a chance of not surviving the thawing, not being able to be fertilized, fertilized eggs not making it to the blastocyst stage, and embryos not implanting successfully. As you can see, the number of frozen eggs to successful implantation varies quite significantly. A woman only needs 1 embryo to implant properly to become pregnant. After that, she would need to ensure she has a healthy pregnancy and give birth to a healthy baby, just like other pregnancies.

With egg freezing, the more you have and the younger you were when you froze your eggs, the more likely your treatments will lead to a live birth.If you're starting with frozen embryos, the same logic goes that the more you have and the younger you were when you extracted your eggs to fertilize into embryos, the more likely your treatments will lead to live birth.

With both frozen eggs and embryos, preimplantation genetic testing on the embryos that matured to the blastocyst stage has shown to help improve the pregnancy outcome, as you are able to see how many of them don't carry genetic defects and are more likely to make it through to childbirth.

The other part of the equation: uterine health

If women continue to be healthy throughout their reproductive years, they are able to carry babies into their 50s. Here are some things to consider:

Uterine health: Some of the issues that arise from aging in the uterus have to do with the structure, blood supply, or hormonal receptivity. With structure, the endometrium, or uterine lining, may begin to waste away or uterine fibrosis may occur. There may be a decreased blood supply to the uterus, making it more difficult to carry a baby to term. The uterus may be less receptive or sensitive to hormones, which may negatively affect embryo implantation.
Increased obstetric risks: With age, there is a higher chance that you have high blood pressure or diabetes before pregnancy, which then lead to high blood pressure and gestational diabetes during pregnancy, as well as other complications like preeclampsia, preterm delivery, spontaneous pregnancy loss, and late fetal death. Women getting pregnant in their 40s or 50s also have higher chances of medical interventions, such as medical induction of birth and cesarean section.
Other considerations: Things like oxidative stress and inflammation can come from dietary and lifestyle, and negatively impact overall and reproductive health. Alcohol, smoking, an inflammatory diet, high stress, and poor sleep are all pro-inflammation and hinder fertility.

Caption: Adapted from Coughlan et al. (2013) https://pubmed.ncbi.nlm.nih.gov/24269084/

An example from US

One long-term study done in New York followed a group of women who froze eggs and used them at a later time. The mean age for egg freezing was 37 years old, the mean for the time of eggs frozen before using them was 6 years, and the mean age when thaw or transfer happened was 44 years old. The study used a small sample but the results are illustrative nonetheless. Out of 80 women who thawed their frozen eggs then fertilized them, 20 (25%) of them had nothing to transfer (either the embryos didn't reach blastocyst stage or the number of chromosomes wasn't 46). The 60 women who had one or more embryo transfers, 27 (34%) of them had live births.

How to improve pregnancy outcomes as a woman in 40s or 50s

Screen, screen, screen: Make sure you screen for overall health, including pre-existing diseases, as well as for uterine health. Women who don't have pre-existing diseases can have favorable pregnancy outcomes.
Prepare your body: Stay healthy and strong, maintain a healthy weight and BMI, and stay away from alcohol, smoking, stress, and sexually transmitted diseases. Having a healthy pre-pregnant body makes a huge difference for conceiving and carrying the baby.
Eat well: Did I mention maintain a healthy weight and BMI? It's so important that it has to be repeated. If you don't know what an anti-inflammatory diet means, start with a Mediterranean diet and consult a nutritionist. Being overweight means reduced chance of embryo transfer and—even if implantation is successful—more pregnancy risks down the road.
Opt for preimplantation genetic testing: If you have the option to do so, this step could save you a lot of trouble down the road. Performing genetic testing before embryo transfer and implantation can help improve the clinical pregnancy rate and reduce the rate of pregnancy loss.‍
Alternative medicine: Acupuncture and herbal medicines are known to be effective in increasing uterine blood flow and improving overall health. There are Traditional Chinese Medicine practitioners and ayurvedic practitioners who are focused on fertility.