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Egg Retrieval for IVF in Women 43+: “Overcooked” Eggs are Common

The Center for Human Reproduction’s Dr. David H. Barad discusses why it becomes increasingly difficult to retrieve healthy eggs in IVF cycles as women age.

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CHR takes care of a good number of women in their early 40s. I think we have had women who are going through ovulation induction right on through 46/47. The oldest patient we have who delivered a baby was 47 (at the time that she delivered). We have a lot of experience in understanding better what the problems of these older women are.

One of the things that we’ve noticed is that when we get the eggs from older women, when using standard treatments, we’re getting a lot of eggs that are so-called “atretic”. Atretic is a term that the embryologists use to describe an egg that’s sort of overripe. It’s like fruit that has been left on the vine for too long. When we say too long, we don’t mean because you’re 43 years old. We mean because the maturation process during the 10-14 days that the egg is maturing in the woman’s body, has gone maybe a day too long (or maybe two days too long). The parameters that we usually use for timing ovulation in younger women have to do with the level of hormones, the estrogen, and the size of the follicle. Normally, a ripe follicle is around a little less than 2cm in diameter. We noted that when we waited that long for our older patients (43,44,45), that we were getting fewer healthy, mature eggs. We found some laboratory parameters that were suggesting that the eggs in the follicles were progressing too rapidly. There are some molecular parameters that we’ve measured, that sort of govern how the eggs grow and govern when they are going to die. It appears that as women age these molecular triggers become a little more hair trigger-ish and go over the edge a little quicker.