A newcomer on our Choice Moms Over 40 discussion board did 12 cycles of IUI before her clinic noticed that she had fallen through the cracks and suggested she try IVF instead. Unfortunately, this does happen. When women find their ChoiceMoms.org peers, it becomes easier to learn what to ask doctors in order to achieve motherhood.
Here is a basic overview of the success rates and generally recommended protocols, as suggested by Choice Mom-friendly Dr. Steve Nakajima (Twitter @DrSteveNakajima), a reproductive endrocrinologist at the University of Louisville.
- In women 40 years and older, the chance of conceiving is approximately 10% per month if no infertility factors exist in the woman or the man who provided the sperm. The decrease in fertility is due to age of the oocytes (eggs); other factors unfortunately lower the chance of conceiving per menstrual cycle.
- IUI with clomiphene citrate may raise the conception rate by 2-3% per cycle, but…
- Women in this age group should usually proceed to IVF after 3-4 unsuccessful attempts.
- If IVF is out of reach financially, then one could perform more cycles of clomiphene citrate/IUI.
- If a woman conceives from an IUI procedure, the miscarriage rate in this age group is approximately 40% per conception and the incidence of Down syndrome is approximately 1 in 100 live births.
- If the woman conceives through an IVF procedure, her incidence of miscarriage and Down syndrome decline slightly, since the best embryos are usually transferred, thus increasing the likelihood of a successful pregnancy.
- Overall live birth rates in women over 40 years old are usually in the range of 20-25% per IVF cycle.
- Over 42-43 years old, live birth rates are usually about 10-15%.
Mikki’s note: I conceived and delivered my second child when I was 42, after two cycles with clomid and several cycles without. And yes, certainly we know many women who are able to conceive in their early 40s. But as Dr. Nakajima, and other reputable REs will warn us, these are the statistics. Some of us feel lucky and want to try without intervention. Some of us see the numbers and want to bet on a protocol that gives us the greatest chances of earliest success. That choice is yours. Simply be aware of these percentages based purely on age factors, not taking into account, as Dr. Nakajima warns, any other fertility factors that might lower chances (those are factors that can generally be discovered from fertility testing).
And certainly, if your current doctor is not talking to you about fertility success rates and your options for treatment, especially after multiple cycles without success, you need to find a doctor who does.