Running out of Eggs?

This is the hardest thing that both patients and fertility doctors have to deal with. Women are born with their entire egg supply and never make new ones and about 10 years before the menopause their fertility declines precipitously. The average age at last birth in normally fertile women is 41. As egg supplies dwindle, then chromosomal abnormalities in eggs increase, leading to reduced implantations and increased miscarriages.

There are many women who know that their egg supply is low because of their age, FSH or AMH levels or previous response to treatment and who wish to know how they may improve their egg quality or egg numbers in an IVF cycle.

There is a large amount of research looking at whether the mitochondria in eggs may be refreshed which may mean that eggs do not age in the same way. Currently, there are no products that have been shown to be effective.

There are a variety of medications that have been used to try and increase response ie egg numbers in an IVF cycle, ranging from increasing doses of IVF drugs, DHEA, LH, testosterone and growth hormone. Increasing the dose of drugs only works to a degree as all receptor sites become occupied. There is no good evidence to recommend the use of DHEA or LH. There are 2 small trials suggesting that testosterone may slightly increase response to IVF drugs and pregnancy rates in women who respond poorly. There are 6 small trials suggesting a benefit with the addition of growth hormone. Fertility Associates is recruiting for the LIGHT study, which is a multi-centre Australasian study aiming to recruit 400 women to properly answer the question: Does the addition of growth hormone in women who respond poorly, improve take home baby rates? If you are interested in being part of this study please contact me on mbirdsall@fertilityassociates.co.nz.

Sometimes the only option is the use of donor eggs. There is an increasing demand for donor eggs and along with it an increasing amount of reproductive tourism which has sprung up. Next week's blog will be about travelling to get a baby, what everyone should know.

To find out more about the difference between trying to conceive in your 30s compared with your 40s, take a look at our website here.