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BMJ. 2007 June 9; 334(7605): 1187.
PMCID: PMC1889954

More women over 40 seek fertility treatment

The number of women older than 40 years being treated for infertility has increased more than 10-fold in the past 15 years, the latest figures from the UK fertility watchdog show.

About one in seven women (15% or 6174 women) seeking fertility treatment was aged between 40 and 45 in 2006, compared with less than one in 10 (9.2% or 596 women) in 1991, according to the Human Fertilisation and Embryology Authority.

The authority says that the increase in older women seeking help comes despite the fact that its data show much less significant improvements in success rates in this age group compared with younger women. The average age of a woman seeking fertility treatment was 34.8 in 2004 compared with 33.8 in 1992.

Angela McNab, chief executive of the authority, said, “Scandinavian countries are seeing this [shift in age of women seeking treatment] more markedly than the UK, and it is a matter of concern. One of the messages that we need to concentrate on as a society is to remind women of the biological clock and the difficulties of achieving a pregnancy over the age of 40.”

It is also important to stress the decreasing success rate with increasing numbers of treatment cycles, she said. Although figures for 1991 to 2004 show that 22% of women having their first treatment cycle will have a baby, this figure drops to 7% of women having their eighth cycle.

Overall the live birth rate per treatment cycle started has increased from 15% in the early 1990s to 21% in 2004, the latest year for which verified figures are available. But success rates vary widely with age. In 1991 the live birth rate was 15.7% for women aged 25-29 years, 17% for women aged 30-34 years, 11.3% for women aged 35-39, and 2.9% for women aged 40-45.

By 2004 the rates had increased to 26% for women aged 25-29, 26.8% for women aged 30-34, 18.7% for women aged 35-59, and 6.9% for women aged 40-45.

Data also show that the number of triplet births fell steadily between 1991 and 2004, with a corresponding rise in singleton births. The number of twin births has remained fairly steady over the same time. Male factor and unexplained causes of infertility have increased, with a slight fall in most other causes.

Overall one in four women treated for infertility will produce enough eggs during ovarian stimulation to allow some embryos to be frozen, which can boost success by 20% in subsequent treatment cycles in women under 35, according to figures presented by Sam Abdalla, a member of the authority and clinical director of the fertility clinic at the Lister Hospital in London.

His data show that it would take three treatment cycles for 40% of women who produce four to six eggs in their first treatment cycle to have a live birth. For women who produce seven to 10 eggs, it would take two treatment cycles for 40% of them to have a live birth.

“The number of eggs a woman produces during the first cycle is a determinant of her success of having a live birth. The more eggs she can produce the faster she is likely to have a live birth,” he said. It is this type of information which needs to be in the public domain to help people decide whether it is worth continuing with treatment, he added.

Notes

The data are at www.hfea.gov.uk.


Articles from The BMJ are provided here courtesy of BMJ Group