IVF in mid-forties?

Dear Professor Winston,

I am in mid forties. I have had 1 child naturally who is now 9 years old. We tried for our second baby when she was 3, I had 2 miscarriages the last one was 4 years ago. I sought treatment at a private clinic. They said there was nothing wrong with either myself or my husband and sent us away. I returned 2 years later and they said IVF was an option but it would not work. We kept trying naturally until I spoke to my doctor who referred me again 18 months ago to the same clinic and they practically laughed me out of their clinic and said I was now too old to have a child. They also said that they could do egg donation but the age limit was 45 and the waiting list was 5 years so it was pointless. My periods are regular and I still ovulate however my egg quality must be the problem. I thought about treatment abroad but I was scared of the unknown. I have all but given up due to my age and the age gap there would be between my first child.

Do you have any advice? We have thought about adoption.


Dear I.,

I will offer an answer because I have great sympathy for you, although I have already answered this or very similar questions previously. Our statistics (which are not essentially very different from those published by the Regulatory Authority, The HFEA, suggest that your chance of a live birth with IVF at your age are around approximately just over 2% – that means we need to treat around 50 patients in a similar situation to get one successful pregnancy. And your chances of a miscarriage are very high indeed if you do get pregnant. The statistics also show that you are statistically still more likely to get pregnant on your own without treatment providing you are having regular sex, that with a single IVF cycle.

The fact that your periods are regular and you “still ovulate” is sadly meaningless. Most women of your age still have regular cycles and the majority also ovulate but this doesn’t give great hopes for conception. I think it might be justified to get your FSH tested a few times and your AMH once. If the FSH is raised much above 12 – 15 units you are very unlikely to conceive with IVF and if your AMH is low, sadly the prognosis is also very disappointing. I would not advise treatment overseas. I do understand the clinic you mention may not have been sympathetic enough on the occasion you went back, but the fact remains it really is an excellent clinic with good doctors and I imagine they did not want to raise false hopes.

My best wishes,

Robert Winston