Friday, May 24, 2019

The limitations of IVF and the problem with the biological clock.

 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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