While
IVF labs are great at making top-quality blastocysts, the problem is that the
chance of a blastocyst from a 40 year old woman getting pregnant is less as
compared to that of a 25 year old woman, even though the morphological grade
and the quality of these blastocysts is identical.
This means that if we have top quality blastocysts , and one is from a 25 year old
and the other is from a 40 year old, and they look exactly the same, the fact
still remains that the 25 year old's top quality blastocyst has a better chance
of implanting and becoming a baby as compared to the 40 year old's.
Now, this is one of the frustrations doctors have with modern
reproductive medicine - we really don't have a good answer as to why this is so
.
One problem is that the energy powerhouse of the eggs -
the mitochondria in the cytoplasm, which drive embryo division after fertilisation
- start malfunctioning as the eggs age. The problem is that we can't test for
this.
Also, we know that as eggs get older, they will have more
genetic errors, as a result of which the
embryos from these will also have more genetic errors, and many of these are
lethal.
The problem is that we can't prevent this - and neither
can we test for them , because PGS only allows us to screen for chromosomal
abnormalities.
This is one of the biological limitations IVF specialists
and older women need to learn to live with.
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