"Aged Mummy" and the need for an ED - really??

When we found out I couldn’t carry a child to term and discovered surrogacy in India, we began to talk about using my eggs and making lovely embryos that we could use in India. Being the research queen that I am, I discovered that I was in fertility terms ‘of advanced age”. As one tactless fertility specialist told me:

“Well if you’ve got money to burn, you could just keep on trying”

For us, and it's not the same for everyone, i had to balance our want to have a child vs my need for that child to have half it's genetic material coming from me and the reality of money. Simply put, we don't have limitless resources. It is not a comfortable place to be in or to get to. The statistics make it much more bleak for those of us in our late thirties and over forty.


The graph below is from the 2006 ART Success Rates report from the CDC, Centers for Disease Control and Prevention, a US government agency. This report was generated from national data from hundreds of clinics and thousands of IVF cycles. The green line shows the IVF success rate by age using the infertile woman's own eggs. The blue line shows IVF data using donor eggs.






The chart shows falling success rates with increasing age starting at about age 30. Infertility increases with age so the curve gets steeper (egg quantity and quality is decreasing at a faster rate) starting at about age 35. At age 44 and above there are almost never babies from IVF using the female's own eggs - the live birth rate using eggs over age 44 is less than 2% per attempt.


Many people are not aware of the decline in fertility as the age of the female partner increases.
There is a slow decline in pregnancy rates in the early 30's. The decline is more substantial in the late 30's and early 40's. So the few kind offers of being our ED from friends in their mid to late thirties starts to look a lot less promising.

Then with continued research i discovered something much worse, well worse for me, miscarriage rate for women with a history of infertility is much higher than for those of fertile women. So, if we do get pregnant with our own eggs ( which is statistically pretty low), the chances of that pregnancy miscarrying is much higher. Great!

The graph below shows national data on miscarriage rates after IVF from the 2006 CDC report (using own eggs). The CDC data only includes pregnancy losses after ultrasound confirmed pregnancy - the miscarriage rate would be higher if very "early miscarriages pregnancies"( 8 weeks or less) were included.





The miscarriage rate after ultrasound confirmation of pregnancy was:
10% at age 25
14% at age 35
28% at age 40
47% at age 43

We decided we wanted a baby, but i decided that using my own eggs would put our dream at risk - and then John and i had the discussion- will we use an egg donor? To be perfectly honest, it was not an easy discussion to have. I have a nephew who looks like me- i wanted that! I didn't want it to be obvious that this child wasn't mine. I was angry that my 42 year old eggs were past there use by date, but John's 42 year old sperm was fine - and yes i do know that it is not that simple, but it didn't make me less angry about the whole "I'm not fertile " drama which came back and slapped me in the face.

Once we started to talk about Egg Donors, the possibilities seem endless until you realise that availability is a significant factor in India. I went through a period of time being quite obsessed about the physicality of our potential egg donor. I wanted a child with John's hazel eyes, not too tall and a bit curvy. I trolled through the two available ED sites that provide Caucasian ED to India and i found my list getting longer. John, the ever practical pointed out two things:

1. I am of Mediterranean descent, light olive skin and brown curly hair and brown eyes, so in the scheme of things, if we did have a child it would more than likely have brown hair and brown eyes and olive skin.


2. Our budget had defined limits and we would need to think about how we spent our money - a Caucasian ED or more attempts at getting pregnant -another angst filled discussion! This became more evident in our conversations when i ended up supporting friends who did spend the 15,000 AUD to bring a ED over only to discover that the ED had their own fertility problems.

Through the misfortune of others, i realised that the best indicator of how an ED would 'perform' ( for the use of a word), is best determined by how they donated in previous ED collection cycles. Just having a child or a termination is not an indication of fertility and does not make your donor a 'proven ED'. Previous ED history is by no means a guarantee, but it does increase the odds.


So, for these reasons, and many more, we have decided to go with an Indian ED ( but Dr. Shivani, if that green/gray/hazel eyed donor comes though the door?) We have decided that we need the following to feel comfortable and optimise our chances of having a live birth:

An ED profile with the following:

1. Proven ED's with previous donation collection information that is available to us.



2. Outcome of previous donations ie live births



3. In which countries those babies reside



4. How many times the ED has donated previously

If you are using an older or unproven ED,( or even if you're not) have a back up plan:

1. Men, leave lots of samples behind, if there are two of you, both leave samples to be frozen,even if you think you probably won't use them now, you might later on ( a sibling project perhaps?).


2. Ensure that you can sign further contracts ( with either a new ED or Surrogate) in your own country and not have to make further trips to India.


3. Keep track that your surrogacy service has a reasonable through put of new ED's and not the same ED's over and over.


4. Make sure that the ED profiles have the information that you need to make an informed decision. If they don't have what you want - ask.

John and i are looking through ED profiles tonight, wish us luck

http://www.advancedfertility.com