Advanced Age

Pregnancies at 35 years of age or older are called late-term pregnancies. Fertility begins to decline in women in their 30s and continues to decline at an accelerated rate after their 40s. The reason for the decline in fertility is that women have a certain number of eggs when they are born and this number decreases over time. The decrease in the potential of the ovaries to produce eggs results in a decrease in pregnancy rates, both naturally and through treatments.

Another important aspect of pregnancy at older ages is the decline in egg quality. According to statistics on this subject; the rate of achieving a pregnancy resulting in a live birth within 1 year is 75% in 30-year-old patients, 66% in 35-year-olds and 44% in 40-year-olds. In addition, in advanced age pregnancies with egg aging, there is a high chance that the pregnancy will end in miscarriage. Gynecological problems such as fibroids and medical problems such as diabetes and goiter are also common with advanced age.

Age-related infertility as well as other female-related causes of infertility:

• Endometriosis (chocolate cyst)
• Low egg reserve and early menopause
• Polycysticover syndrome
• Tube blockage
• Endocrine diseases that cause ovulation disorders
• Vaginismus

Attention to Advanced Pregnancy!

Women are 50% less likely to become pregnant after their 40s. Therefore, if pregnancy is planned at this age, the woman’s general health should also be taken into account. Although many women who become pregnant at an advanced age give birth to healthy babies, the risks are higher than for young expectant mothers. The feared complication in older pregnancies is giving birth to a baby with chromosomal abnormalities. The most common complication is Down syndrome, which includes mental retardation and some heart and organ abnormalities. However, prenatal tests during pregnancy, especially amniocentesis and chorionic villus biopsy (the removal of a piece of tissue from the placenta, which provides communication between mother and baby, with a thin needle or stick under ultrasound control) can identify these babies.

IVF Treatment in Older Women

It is very important not to lose time in the examination and treatment steps of elderly patients. If pregnancy has not occurred with unprotected and regular sexual intercourse for 6 months if the patient is 35 years of age or older, and 3 months for 40 years and older, a doctor should be consulted. Although it varies according to the general health status of the couple, it is possible to achieve success in IVF treatments with today’s technology in elderly patients.

Embryo Transfer and Technology in IVF Treatment

There have been significant developments in embryo and egg freezing in IVF treatment. Now embryos can be frozen individually and 99% of them are intact when thawed. In women whose uterus is not well, whose hormones do not respond, or who have problems during treatment, we can freeze the embryo at any time and thaw it when the chances are best. In addition, with the development of medium fluids used in the laboratory environment, embryos can be taken to day 5 more easily and embryos that have reached day 5 have a better chance of attaching to the uterus than day 3. This leads to a significant increase in the pregnancy rate. One of the most important areas where technology is utilized is in vitro fertilization treatment and there are serious developments especially in egg and embryo freezing.

How Many Embryos Are Transferred in IVF Treatment?

In IVF treatments, one embryo can be transferred in the 1st and 2nd attempt in patients under 35 years of age, 2 embryos in subsequent attempts, and 2 embryos in patients over 35 years of age.

The methods we apply in IVF treatments:

Embryoscope

Embryoscope is a system that can monitor embryo development 24/7. In IVF treatments, embryo development is one of the most important factors that lead to pregnancy. Being able to continuously monitor embryo development with the embryoscope device ensures that the embryo with the healthiest and highest pregnancy rate is selected.

Uterine Resting Method

Recent studies have shown that the hormones or medications used to grow eggs have a negative effect on the lining of the uterus and therefore reduce the ability of the uterus to accept the embryo. In order to eliminate this effect, the quality embryos obtained during the treatment are frozen and the treatment is interrupted for 1-2 months to allow the effect of the medication to disappear and the uterus to return to its natural state. This treatment, which allows the uterus to easily accept the embryo, is called the “uterine resting method”.

NGS (Next Generation Sequencing Technique)

NGS is a genetic analysis technology that enables comprehensive chromosome screening of embryos. With NGS, embryos are screened quickly and effectively and genetic problems at the chromosome level can be detected before pregnancy. Chromosomal abnormalities in embryos are one of the most important reasons for the failure to achieve a healthy pregnancy despite the successful transfer of embryos to the uterus in IVF treatments. Detailed chromosomal screening using the NGS method plays an active role in detecting chromosomal abnormalities in embryos. Especially in patients with recurrent miscarriages and candidates who want to have a baby over the age of 40, treatments are carried out by transferring the embryo, which is determined to be chromosomally healthy by the NGS method, to the uterus.

MitoScore (Energy Scoring)

MitoSkor is an application that allows the energy status of embryos to be monitored. The app measures the amount of genes in the mitochondria, the “energy furnaces” of the cell, in order to identify the healthiest embryo.

CD 56 – Serum Therapy

These cells, known as natural killer (NK) cells, whose numbers in the uterus are altered for different reasons, have a negative effect on the occurrence of pregnancy. The CD 56 test is a test that detects the density of these cells in the lining of the uterus. In spontaneous pregnancies or pregnancies achieved through in vitro fertilization, many molecular mechanisms are activated during the implantation of the embryo in the uterine lining. In these mechanisms, it is of great importance that the immune system is at the appropriate level for pregnancy. A high or low level of NK cells in the uterine lining can negatively affect the implantation of embryos in the uterus. An excess of these cells in the uterine lining can lead to pregnancy losses. It can be recommended for patients who have experienced 2 or more miscarriages or for patients who have not achieved pregnancy despite transferring 4 or more embryos in previous IVF treatments.

Pool Method

The pool method consists of 2 or more egg retrieval procedures (OPU) and freezing the embryos before embryo transfer. In this method, the embryos in the pool are thawed together and (if necessary) transferred into the uterus prepared naturally or with medication under follow-up. The correct application of the embryo freezing technique plays an important role in obtaining positive results from the pool method.