Find here the list of best IVF doctors in India on the basis of Ratings, Success Rate, Services offered, IVF cost packages and available Facilities. Dr. Nisha Bhatnagar, Dr. Kaberi Banerjee and Dr. Anjali A Deval top the list of such IVF doctors in India due to their unique pricing system, popularity and high success rate.
IVF treatment in India has a high success rate for women above 40 years of age. Fertility and quality of eggs decline gradually from age 30, and conception chances fall to 5 percent by age 40. The IVF success rates also increase with donor's egg and sperms. Nutritious food elevates the chances of getting pregnant.
Today, women are intentionally delaying marriage as well as childbearing for a number of reasons. These possible reasons can include specific career goals, independent lifestyle, education, a desire to be in a stable relationship or first become financially secure. Since some 40-year-old women, today feel like they are in their 30’s, they expect their bodies to stay and act young as well. Unfortunately, the human reproductive system does not work in their favor, so the more they delay the chances of conceiving naturally or through IVF treatment also decreases. Fertility in women naturally starts declining around the age of 30 and takes a steeper decline after age 35. By age 40, the chances of conceiving, without Assisted Reproductive Technology (ART), are about 5 percent per menstrual cycle. A woman over 40 years of age has the best chance to conceive and give birth to a healthy child through In Vitro Fertilization (IVF) procedure. Women usually face reduced ovarian reserve once they cross the mid 30's. The eggs cannot create a viable embryo, therefore, the woman has little chances of conceiving naturally.
In the 40s during ovulation, a woman rarely produces normal eggs in comparison to abnormal eggs. If the produced embryo is healthy and normal, then it is good news. Otherwise, the embryo formed the eggs will fail to implant itself in the uterus naturally leading to a miscarriage or genetic abnormality in the child such as Down's syndrome. There is a viable difference in the quality of an egg a woman produces at the age of 20 and at the age of 40. The quality also depends on the overall health condition of a woman who produces it. Women in their late 30s and 40s have a likelihood to produce abnormal eggs due to their weak reproductive system. The abnormality of an egg decreases the fertility levels in a woman with their increasing age and this is commonly observed in many cases of women above 35. The chances of having a premature baby or the small gestational age baby are higher in a woman above 40s. Small for Gestational Age (SGA) refers to a baby with less weight than other same gestational age babies. (7) It is also observed that woman attaining IVF procedure with their own eggs experiences a low success rate. Whereas, using donor eggs from a young woman posses more than 51% increase in the chance of having a pregnancy.
In this article, we will look at:
- What are the problems women above 40 years face while trying to conceive?
- Why women over 40 have problems conceiving?
- What are the chances of getting pregnant at 40 years?
- What IVF Success Rates for Women Over 40 Years?
- What are the Natural Ways to Increase Fertility?
- Likelihood of Pregnancy at 40 years with IVF Treatment
Due to the reduced chances of conceiving naturally, and with limited time left in their reproductive life, many women over 40 start losing hope to get pregnant. In the end, a woman above 40 finds more sense in turning towards IVF treatment as soon as possible. Most fertility centers first prepare the patient's reproductive system to become active for examination and then provide with less invasive infertility treatments like ovulation stimulation medication with IUI. If this primitive treatment is unsuccessful, they move to IVF. Each procedure is generally tried twice before moving on to the next treatment. A woman's body over the 40s generally exhausts all good quality eggs by using up valuable time for pregnancy and ovarian reserves. That is why many best IVF clinics in India and qualified doctors unanimously recommend IVF treatment straight away for people over 40 years.
A woman faces minimal complications when she conceives and delivers her baby during her 20's and 30's. Although, the advanced age of women in their 40s becomes the most relevant complication itself due to reduced reserve and quality of eggs. In their 40s and prominently after 35 years, a woman's body begins to show some prominent changes in the reproductive system. (6) These reproductive problems may give rise from minor to major complexities during pregnancy. It is seen in most of the pregnancies, that woman above the age of 35 needs to receive next level care and nutrition to sustain a pregnancy. Many healthy women maintain a certain lifestyle by practicing yoga and sticking to a healthy diet. Unfortunately, most of the difficulties are suffered by working women due to their work commitments. The first trimester during pregnancy is the most crucial stage when an embryo undergoes several major changes and developments. During the first few weeks, an expectant woman has to avoid stress and completely focus on her pregnancy. Moreover, during their 40s, a pregnant working woman should not take any risk with their pregnancy and try to take as much rest as they can. As women are born with a finite number of follicles (eggs), a decline in fertility is natural as there is a decrease in the number of eggs with successive time. Moreover, environmental hazards, consumption of harmful substances and lifestyle habits also contribute to the decrease. Even when a 40-year-old woman still has around 10,000 eggs, it is just 3 percent of the original 300,000 presents at the onset of puberty. The follicles also accumulate mutations over time like a breakdown of DNA repair mechanisms, further, rate of failed fertilization, miscarriage and birth defect decreases fertility levels in the body.
There are many reasons why women over 40 have trouble in conceiving, some of them include:
- Ovary dysfunction
- Declining Fertility: Increasing infertility in her male partner due to his advanced age may affect conception.
- Early or late ovulation in a woman above 40: Women are more likely to have health problems, like hypertension or diabetes, which affect fertility.
- The quality of eggs (Not all eggs are viable or can’t be fertilized)
Ovary dysfunction: A female fetus is in her mother's womb consists of a certain number of eggs and the reserve reduces over the years till she reaches her 50's. Once a woman's period naturally begins, her considerable number of viable eggs starts declining. The waning of eggs and their quality leads to a vital reason for reducing fertility in a woman.
Primary Ovarian Insufficiency (POI) remains an unfavorable condition in which periods stop before the correct time, around the age of 40 in a woman. Usually, a better term used here is menopause, which normally occurs to a woman around the age of 52. If menopause occurs early is called Primary ovarian insufficiency (POI). During POI the ovaries work irregularly or completely stop working. The transition journey of a woman around the 40s begins towards menopause, due to which they suffer irregular periods. In more than 90 percent cases, the reason for POI is still unknown. In fact, POI may also happen to women due to infection, disease, chemotherapy or radiation. Many women during POI yet experience irregular periods and in rare cases, a woman has also conceived. (2)
POI is directly linked with the ovary follicles. These follicles are the small sacs in the ovaries, where the process of growing and maturing of eggs takes place. Altogether, there are two types of problems in follicles:
- Early stagnation of working follicles.
- Inappropriate working of follicles.
Below are a few reasons for the occurrence of Primary Ovarian Insufficiency:
- Fragile X syndrome and Turner syndrome a genetic disorder
- Less number of follicles
- Thyroiditis and Addison disease along with Autoimmune diseases
- Radiation therapy and chemotherapy
- Metabolic disorders
- Intoxication due to cigarette and pesticides
Declining Fertility: Another problem a woman faces during her 40s is low sperm count and decreased quality of her male partner. The advancing age of the male partner affects the conception directly. In elderly age, it becomes difficult for male sperm to reach the fallopian tube of a woman to fertilize the vital egg for the formation of an embryo. The reason remains to be low sperm motility and enough number of healthy sperms to penetrate the egg. Therefore, many elderly couples choose to go for In Vitro Fertilization (IVF) treatment. In IVF treatment, the sperms and eggs are penetrated outside the body in an IVF laboratory. After the embryo is created, it is placed inside the uterus of a woman to be conceived. As per research by The New England Journal of Medicine, a woman who was treated with artificial insemination in a certain age has the following results (1):
- Under 31 of age: Within a year, 74 percent of women conceived.
- Between the ages 31 to 34: Within a year, 61 percent women conceived.
- Age of 35 and above: Within a year only 54 percent of women conceived.
Early or late ovulation in a woman: A woman only ovulated for 3-5 days every month. Sexual intercourse attempted at the time of ovulation is considered to maximize the chances of occurrence of pregnancy. The ovulation period is popularly known as a 'Fertile Window'. A fertile window comprises of total 5-6 days when an egg released from an ovary. These days include five prior days and an additional one day when the egg is released. Active intercourse during these specific days may lead to a successful conception in the woman. A question arising here, how can 5 days back sexual intercourse lead to intended pregnancy, if the viable eggs rupture after one to two days of having sexual intercourse? Below are the two reasons listed (3):
- Life of sperm sustains for five days.
- Fertilization of mature eggs can only take place within 24 hours (1 day) after being ruptured from the ovary.
As sperms and eggs have precisely a shorter life span, their fertilization during the correct time period becomes prominent. Sperms with five days of life spans may stay inside the fallopian tube waiting for an egg to fertilize.
Quality of Eggs: The immature eggs or a primordial egg inside the ovaries ruptures every month during ovulation. A woman above the age of 40 may develop abnormal eggs at the time of rupturing. When a cell ruptures out from the follicles undergoes another phase of dividing itself, the phase is known as meiosis. During that process, a cell may add errors while forming their DNA. These errors lead to abnormality in eggs via genetics. A woman with an older age tends to have aneuploid eggs because of the poor quality of eggs. Till now there has no technology developed to rectify this error in eggs. Therefore, under IVF best quality of eggs is retrieved for the fertilization process. The eggs can either be of good or normal quality "euploid" or bad quality "aneuploid". As the woman ages, her quality of eggs starts becoming poorer and poorer. Damage during the division process of cells to form eggs may develop a condition where a cell would not perform the way it should. DNA is like a manual, which the cell (egg) has to follow by becoming a healthy baby, but a problem in DNA may cause unhealthy or an abnormal baby.
Chances of chromosomal abnormalities in eggs are much higher. Chromosomal abnormalities in eggs as per age:
- 30 percent at 30 years
- 60 percent at 40 years
- 90 percent at 44 years
Even though it is still possible for women over 40 to conceive naturally, there is no denying their chances of getting pregnant are very low. This happens since fertility begins to decline around the age of 32, which becomes more rapid at 35, and by age 40, the fertility of a woman has to drop down by half.
- At 30 years there is a 20 percent chance of getting a pregnant per cycle
- At 40 years there is a 5 percent chance of getting a pregnant per cycle
- At 45 years there is a 1 percent chance of getting a pregnant per cycle
IVF success rates even in the 40s are moderately good. For women over 40 years of age, the success rate of IVF with their own eggs, per egg retrieval cycle, remains 6 percent. The chances of a successful live birth using donor obtain 40 percent. The IVF success rate when using donor eggs is significantly high. The effective use of donor eggs during IVF after age 40 offers women the same chance for a successful pregnancy as a younger woman. Donor egg babies, in addition, have a lower chance of genetic defects which gives higher IVF success rates in live births.
In India, a normal IVF treatment respectfully gives around 30 to 35 percent desired results, irrespective of mature age. As per the WHO report, they have universally observed a significant downfall in the number of sperm count, morphology, and motility after the age of 35 in men. However, the success rate of IVF procedure varies from one woman to another. In IVF procedure, it is perceived that not only an egg of a younger woman is healthy, but viable egg frozen at an early age is as helpful as a donor's fresh egg. A frozen egg has higher chances in implanting itself in the uterus of a woman. (8)
The best way to increase one's chances of getting pregnant at 40 is to make sure one is having unprotected sex at the right time in your cycle.
One must also need considering:
- Lifestyle Changes: A healthy lifestyle with a good diet full of protein, nutrients, and calcium, adequate exercise, not smoking and reducing alcohol and caffeine intake.
- Reduce Stress Levels: It is proven that stress interacts negatively with reproductive hormones in men and women.
- Eat food enriched with Antioxidants: Folate and zinc being rich in antioxidants elevate fertility in both men and women of elderly age. It helps in reducing free unwanted radicals from the body. As per research underwent on 60 couples, found that consuming antioxidants along with In Vitro Treatment (IVF) has increased the results to 23%.
- Eating less refined carbs: Refined carbs are harmful and problematic as well for women who are trying to conceive. It includes extremely sugary food and drinks. These foods include white pasta, rice, and bread.
- Fiber Diet: Consuming more and more fiber will maintain the balance of healthy hormones. It reduces the excess level of hormones while maintaining the sugar levels in the blood. Some specific fibers even help in holding the estrogen in the intestines only and removing extra estrogen. (4)
- Eat Fish: Fish is a multipurpose food and have high omega-3 fatty acids. Omega-3 is very important for our body in maintaining the levels of cholesterol and increasing the ability to get pregnant. However, to become pregnant one should avoid having fish with high mercury. One can consume Salmon, Scallops, and Shrimps to have the necessary nutrients.
Tips to get pregnant in the '40s:
- Keep the uterus warm: As per Chinese medicines having a cold uterus signifies infertility and lowers the chances of getting pregnant. A place where a baby grows needs to be warm and healthy. If a woman experiences menstrual bleeding to dark purple or black then it tends to have excessive blood clots in their body. Eating warm food and working on blood circulation therapy may help in achieving pregnancy even in the '40s. (5)
- Drink bone broth: A soup or bone broth having a high content of bone marrow may lead provide lots of amino acids to increase fertility in a woman above 40 years of age.
- Healthy environment: One should focus on living in a healthy environment. About 80,000 chemicals are active in America and the case similar or worse in many other countries. One must keep herself away from cleaning products, pesticides, and home care products, which may go inside the body in any way. It is popularly said which cannot be eaten must not be applied to our body. Therefore, considering natural products will restrain the harmful chemicals that go inside the body.
However, if you have tried all of the above methods without any positive results, it is important you seek medical advice without wasting any more time.
As the chances of falling pregnant naturally over 40 years are below 5 percent, many couples in India decide to increase their chances with assisted reproductive technologies such as IVF. There are many success stories of couples conceiving successfully through IVF treatment in India even above the age of 40. The IVF doctors in India follow advanced techniques in IVF treatment using modern devices and precisely perform the treatment. The IVF experts ensure the appropriate date of ovulation, quality of embryos cultured and a number of embryos to be implanted. If a woman has any hormonal imbalance, the procedure is performed with stimulating hormone medicines. Women who do not possess healthy eggs are recommended for donor eggs to improve the chances of success. Most of the IVF clinics in India are associated with trusted sperm and egg banks to obtain high-grade eggs or sperms. The IVF success rates in India is more than some countries as most of theIVF doctors have vast experience in this field. At an average, a woman’s chance of getting pregnant at 40 years with natural IVF treatment is 9 percent, while the chances with mild IVF treatment (using stimulating hormones) are 20 percent. However, it is important to note that a woman's chance of IVF success is dependent on her own specific circumstances, the cause of infertility and the treatment they receive for successfully conceiving a baby.
If one is looking for the best IVF clinic in India for your infertility treatments, OVO Fertility is one of the leading reproductive healthcare facilitators who can help to find the best IVF clinic in India. One can compare the list of doctors on our platform and find the more suitable doctors for one's treatment, or one can simply leave it to us to recommend the best treatment for the patient. We also provide consultation and medical loans to help infertile couples go through their journey of infertility treatment without any difficulty. One can also call us on +918268260808 to book a free appointment with the best IVF doctors in India.
SOURCES AND REFERENCES:
- ^ Pregnancy after 35 - Medical News Today Medicalnewstoday.com, 23 May 2019
- ^ Primary Ovarian Insufficiency - Mediline Plus Medlineplus.gov, 23 May 2019
- ^ Getting the Timing Right - Your Fertility Yourfertility.org.au, 23 May 2019
- ^ 17 Natural Ways to Boost Fertility - HealthLine Healthline.com, 23 May 2019
- ^ 12 natural ways to improve fertility - Fox News Foxnews.com, 23 May 2019
- ^ Understanding how to improve your chance of having a baby - Your Fertility Yourfertility.org.au, 23 May 2019
- ^ Small for Gestational Age - Stanford Childrens Stanfordchildrens.org, 23 May 2019
- ^ 40 years of IVF - Hindustan Times Hindustantimes.com, 23 May 2019
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