Is it possible to get pregnant naturally after the age of 44, 45?

So many patients ask this question to our doctors. “The increase in maternal age – explains Filippo Maria Ubaldi, Director of the Scientific Executive Committee of GeneraLife – brings a reduction in the pregnancy rate and above all an increased risk of abortion. This happens because the ageing of the woman leads to a double oocyte damage: quantitative and qualitative. The chances of obtaining evolutionary embryos, in a natural way but also in vitro, are significantly reduced, especially after the age of 40 years. And the chances that the embryos obtained are chromosomally normal are already reduced after 35 years.

There are therefore three strategies available in a Pma center, depending on the age of the patient: prevent (with correct information and possibly the preservation of fertility and thus cryopreservation of the oocytes), compensate (through customized oocyte stimulation to try to maximize the chances of success per treatment) solve (e.g. with Ovo donation, when there is no longer a reasonable chance of success with the woman own eggs), always having as first objective to reduce the risks, all through embryonic selection and transfer of a single blastocyst.

The advice we want to give to all people and couples is to pay attention to their reproductive health from an early age, informing themselves, undergoing regular checks and adopting the rules of healthy living. Science can help more, if the would-be parent has always kept a watchful eye on her reproductive health. But till when is the case to try with the woman’s own eggs. Alberto Vaiarelli, gynecologist responsible for the treatment of PMA at the GeneraLife center in Roma, explains that “the factors that must be taken into consideration before being able to state that own eggs assisted fertilization is a too difficult road for the couple, are these: maternal age; the ovarian reserve and the potential response to hormonal stimulation; the number of Art treatments undertaken and previously failed and also how long the couple is trying to get pregnant.

In addition, of course we must take in account the male factor. However, the advancing age of the woman brings with it an important qualitative and quantitative damage to the oocytes and higher clinical risks. Ovarian reserve is an important indicator, but we cannot go beyond some limits that nature has set, not even by increasing the dosage of hormonal stimulation. Of course, today there are personalized and promising approaches, such as DuoStim, the double stimulation in a single cycle, but the management of patients over 43 years old cannot be separated today from an extensive and in-depth counseling concerning these clinical and biological data”.