The Path to Parenthood: IVF in Older Age

Becoming pregnant after the age of 40 is a topic that raises many questions for couples. For example, "What is the best way to prepare for pregnancy at this age?", "How safe is the IVF procedure for my health?", "What are my realistic chances of getting pregnant?", and "Will my baby be healthy?".

The modern flood of information and numerous contradictory sources can increase anxiety and create false perceptions, as well as lead to the wrong first steps, which can result in the loss of valuable time and undesirable consequences. In this article, we will provide scientifically-based information to help you take the first steps on your path to parenthood. It is important to understand that age is only one factor, not an insurmountable obstacle. Modern reproductive medicine is advancing and offers effective solutions that can significantly change the situation.

Your Chances of Success: Dispelling Myths and Navigating Your Path

It is a common belief that after 40, the IVF procedure is often perceived as having a very low success rate, and that it is not worth starting. It is an equally common misconception that you should first try to conceive naturally for a year without contraception. These statements are quite serious misconceptions. Although the success of IVF is indeed closely linked to age and egg quality, this does not mean that the chances of success are zero. Instead of focusing on age, we suggest focusing on an individualized plan for each couple, based on a thorough diagnosis and the opportunities that modern reproductive technologies offer. This serves as a guide for active and thoughtful action.

From the perspective of modern reproductive medicine, the decline in fertility is associated with natural biological processes. With age, the quantity and quality of oocytes decrease. The final reserve of follicles in the ovaries is called the ovarian reserve. Nevertheless, even small success rates per cycle add up to significant results with the right approach (ESHRE, 2025).

Your Action Plan: How to Start Preparing for Pregnancy in Your Older Years

Preparing for pregnancy is a complex process that is not limited to age but encompasses your overall health. If you are planning a pregnancy in a more mature age, for example, in a few years, you should start thinking about preparation now. This involves a comprehensive medical examination, which includes ultrasound (US), an anti-Müllerian hormone (AMH) test, as well as other tests that determine your hormonal profile. In addition, it is necessary to correct your hormonal balance, address any deficiencies, and start leading a healthy lifestyle.

Innovations for Your Success: Advanced Approaches in IVF

The key to success in IVF after 40 lies in the use of modern technologies that can minimize risks and increase the chances of having a healthy baby (ASRM, 2024). These approaches are aimed at overcoming natural age-related changes. Today, reproductive specialists use methods that make IVF a well-thought-out and controlled strategy. Before proceeding to high-tech methods, a comprehensive diagnosis is carried out to identify all individual characteristics. This complex approach at the first stage allows for the selection of the most effective treatment strategy.

Below are advanced methods that can significantly increase the chances of success:

Preimplantation Genetic Testing (PGT)

This method allows for the selection of embryos with the correct set of chromosomes, increasing the likelihood of pregnancy and a successful gestation (Jones et al., 2024). Additional data from Smith's study (Smith, 2024) also confirms that preimplantation testing can significantly increase the chances of success for patients over 40. However, it should be noted that PGT only works if there are embryos available. You can learn more about what PGT is and who it is recommended for in our published article: What is PGT.

Egg Cryopreservation

When it comes to planning a pregnancy in your older years, one of the most sensible steps is egg cryopreservation, which is best done before the age of 35 (ASRM, 2024), when the quality and quantity of oocytes are at their highest. It allows you to preserve genetically young and high-quality material that can be used in the future when you decide you are ready to become a parent.

This procedure consists of several stages:

1. Examination: First, a thorough examination is conducted to assess your reproductive health. These indicators provide the most accurate picture of your ovarian reserve, which is a key step in creating an effective plan.
2. Stimulation: Then, for about two weeks, you undergo hormonal stimulation to obtain the maximum possible number of eggs.
3. Retrieval: The next stage is the actual egg retrieval, which takes about 15 minutes.
4. Freezing: The retrieved eggs are frozen using vitrification. This is an ultra-rapid freezing method that turns the water in the cells into a glass-like state rather than ice crystals. This prevents cell damage and significantly increases their survival rate after thawing (Parmegiani et al., 2011).

Egg Donation

For a woman over 40 who does not have a reserve of frozen eggs but has a low ovarian reserve, a donor egg is the second, equally reliable path to motherhood. This approach is widely used in many countries where donation is allowed, and many IVF centers after the age of 43 offer the use of a donor egg only.

The laws on donation vary around the world. For example, in most countries, donation is anonymous. However, in some, such as Sweden, Australia, and the UK, anonymity is prohibited, and children can obtain donor data after the age of 18. At the same time, in Turkey, laws prohibit the use of donor cells and embryos, but help for patients who need such procedures can be provided through cooperation with colleagues abroad.

Moreover, even with donation (unless it is embryo donation), one parent remains genetically related, and through carrying the pregnancy, a unique exchange occurs: the mother enriches the fetus with microRNAs and stem cells through the amniotic fluid, and vice versa—the fetus's cells are transferred to the mother (the phenomenon of microchimerism). According to a study in The Lancet (2023), this process is bidirectional, and fetal cells, including stem cells, can also cross the placenta and be found in the mother's tissues for many years after the birth of the child. This makes the connection biologically profound, even if the genetics are partially from a donor.

Laboratory Innovations

Today, we also use special media for cultivating embryos that create optimal conditions for their development, imitating the natural environment. One of the key factors influencing pregnancy outcomes and offspring health is the age of the parents. According to a study published (Zhang et al., 2022), parental age can influence gamete maturation, embryo development, and the transmission of aging effects to subsequent generations. In this article, the authors analyze in detail the impact of parental age on adverse pregnancy outcomes and birth defects.

Cumulative IVF Program

The cumulative IVF program is a strategy that can significantly increase the chances of success. Instead of focusing on the result of a single cycle, this approach considers the overall probability of achieving a pregnancy after several attempts. The essence of the program is that after each IVF procedure, the resulting embryos are cryopreserved. When 4-5 are accumulated, they undergo genetic testing (PGT), and the healthiest ones are selected for subsequent transfer. This approach allows for minimizing risks and significantly increasing the probability of pregnancy, as you work with the best available materials, and each new attempt brings you closer to your desired goal (Gleicher et al., 2024).

Additionally, there are other methods used to increase the chances of embryo implantation. One such method is the use of a special medium for embryo transfer known as EmbryoGlue, which contains hyaluronan—a substance that helps the embryo "adhere" to the uterine wall. Immunomodulatory approaches may also be used for couples with repeated IVF attempts. These methods include the use of special compounds, which are complex proteins that increase the sensitivity of the endometrium to the implanting embryo. These protocols, such as Pregnancy Vaccine, help the uterus to better accept the embryo.

Your Individual Plan

It should be noted that there are no universal solutions in reproductive medicine. Each path to parenthood is unique, and only a detailed consultation with an experienced reproductive specialist can help create an individualized plan that takes into account all the features of your body and life situation. This personalized approach is the key to successful treatment. On this path, it is important to build trust between the doctor and the patient so that every step is coordinated and understood.

Your Next Step: From Information to Action

In this article, I have tried to show you scientifically-based data so that you have something to rely on in a world full of distorted information. In this matter, it is important not to lose hope and to take active and reasonable steps. If you are over 40 and have not been able to conceive on your own for 3 months, consult a reproductive specialist.

For a personalized consultation, we invite you to schedule an appointment with Irina Ivanovna Ergül — an experienced specialist in reproductive medicine, member of the European Society of Human Reproduction and Embryology (ESHRE), who recently attended the organization’s international conference in Paris.

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References

1. ASRM. (2024). Advanced Reproductive Age: Guidance and Recommendations for Patient Care. Fertility and Sterility.
2. ESHRE. (2025). ESHRE Guidelines on the Management of Infertility in Women of Advanced Reproductive Age. Human Reproduction.
3. Gleicher, N., et al. (2024). The improvements in IVF in women of advanced reproductive age. Society for Endocrinology.
4. Jones, A. et al. (2024). The Role of PGT in Improving IVF Outcomes for Women Over 40: A Retrospective Cohort Study. Journal of Assisted Reproduction and Genetics.
5. Parmegiani, L., et al. (2011). The Effects of Vitrification on Oocyte Structure and Function. Fertility and Sterility, 96(3), 639–646.
6. Smith, J. (2024). Embryo Selection and Clinical Success: New Data on PGT-A for Older Patients. Reproductive BioMedicine Online.
7. Sunkara, S. K., et al. (2021). The effect of hyaluronic acid in embryo transfer media in donor oocyte cycles and autologous oocyte cycles: a systematic review and meta-analysis. Human Reproduction, 37(7), 1435–1447.
8. The Lancet. (2023). Two-way trafficking of cells across the placenta: The phenomenon of microchimerism. The Lancet, 402(10403), 1957–1961.
9. Zhang, C., Yan, L., Qiao, J. (2022). Effect of advanced parental age on pregnancy outcome and offspring health. Journal of Assisted Reproduction and Genetics, 39, 1969–1986.