What is the 5% chance at 42 based on?

[Anonymous]

Like many people on this site, I am 42 and TTC. We have two children (one IVF, one natural) and we want a third. A FET this past January was not successful and we were told there is only a 5% chance I will be able to concieve naturally and of course, a high chance of miscarriage if I do. I was wondering what that 5% statistic is based on (and didn't think to ask the RE at the time)? Is that 5% of all women who try to conceive? How many 40YO+ women out there are trying to conceive to being with? I would think the majority must be younger overall. So then is it 5% of women who are being treated for infertility? Wouldn't these rates be lower for a number of reasons besides age? Is it based on how many women over 40 give birth overall? I am just trying to understand exactly where this number comes from.

I was ovulating regularly before the FET, which seemed to have somehow thrown me off track for several months afterwards. Now I am ovulating again and using the Clear Blue Fertility Monitor but only for 2 months so nothing yet. We had so much sex during my fertile time that it's hard to believe I didn't get pregnant. Then again, it's also hard to believe I am 42.

[Anonymous]

OP here. Also, can someone tell me more about ovarian reserve testing? Shouldn't this be done first before telling someone you only have a 5% chance of carrying a baby to term? I had first baby at 38 and second at 39. It's so hard to believe that my eggs are not good enough anymore. Clearly, I am in denial about being 42 and what that means with regards to fertility!

[Anonymous]

I don't know where that stats comes from but I think it's baloney. It's very difficult to measure the rate of conception in the general population. And even if it were possible, that rate is not necessarily applicable to any individual case. You already have 2 children, so it's likely different than the rate for someone with no children, or a different level of hormones, who tried for a shorter time etc. You really need to know the stats for people like you (not just in terms of age, but several other relevant factors), but of course that rate is not available.

I am also getting increasingly angry when those rates are quoted by my RE. Oh, really, I am 39? Thanks for the news. Now please explain why I am paying you $$$ if you can't do anything about it.

[Anonymous]

There is a sharp decline in a woman’s ability to achieve pregnancy over age forty. The fertility rate per month is only about 5% and even with in Vitro Fertilization (IVF), the most successful infertility treatment available, the pregnancy rate is only about 10% per try. This is due to the greatly reduced number of normal eggs. Estimates from embryo biopsy reveal that at least 90% of a woman’s eggs are genetically abnormal when a woman is over 40.

[Anonymous]

Anonymous wrote:There is a sharp decline in a woman’s ability to achieve pregnancy over age forty. The fertility rate per month is only about 5% and even with in Vitro Fertilization (IVF), the most successful infertility treatment available, the pregnancy rate is only about 10% per try. This is due to the greatly reduced number of normal eggs. Estimates from embryo biopsy reveal that at least 90% of a woman’s eggs are genetically abnormal when a woman is over 40.

But people who go to IVF are not a random sample; they are significantly worse (having more problems) than average. This is where the question "what is this rate per month based on" comes from. How is that rate computed, based on what sample, with what history? It would be helpful to know stats for lesbians over 40, for example; or, in this case, for 42 year old women who had no problem conceiving 2 children at ages 38 and 39. Yes, there is drop in fertility, no doubt, yet there is also a significant variation among individuals. If this were not the case, OP could not have conceived her two children so easily.

[Anonymous]

OP here. This is exactly what I mean. For lack of a better word, is the 5% statistic for "normal" people or only known for people TTC using a RE?

[Anonymous]

CDC records rise in birth rate for women over 40By the CNN Wire staff
April 1, 2011 7:50 a.m. EDT
STORY HIGHLIGHTS
CDC: Birth rates rise 6% for women over 40, drop for all other age groups
Study finds total U.S. births dropped from 4.3 million in 2007 to 4.1 million in 2009
Hispanic women experienced the largest decline in births, CDC says
(CNN) -- The birth rate for women over 40 in the United States rose between 2007 and 2009. Among every other age group, however, the birth rate fell during the same period, according to a report released by the Centers Disease for Control and Prevention.

According to the study, women between 40 and 44 experienced a 6% increase in birth rate during the time period. There were 9.5 births for every thousand women in that age group in 2007, 10.1 births per thousand in 2009.

Younger mothers had more babies per thousand women during the time period, however, birth rates declined for every age group under 40, according to the study released Thursday.

The study also found that after reaching an all-time high of 4.3 million births in 2007, the number of babies born in the United States dropped 4% to 4.1 million in 2009. A provisional count taken between 2009 and June 2010 indicated a continued fall in births, the CDC said.

Fertility rates also dropped for all major racial groups in the United States during the study period. The largest decline was among Hispanic women, for whom birth rates declined 9 percent between 2007 and 2009.

The decline in births from 2007 to 2009, the report stated, "is relatively small in a historical context compared with the declines in the early 20th century and in the 1960s and early 1970s."

The report was prepared by researchers in the CDC's National Center for Health Statistics, Division of Vital Statistics, Reproductive Statistics Branch.

[Anonymous]

Anonymous wrote:CDC records rise in birth rate for women over 40By the CNN Wire staff
April 1, 2011 7:50 a.m. EDT
STORY HIGHLIGHTS
CDC: Birth rates rise 6% for women over 40, drop for all other age groups
Study finds total U.S. births dropped from 4.3 million in 2007 to 4.1 million in 2009
Hispanic women experienced the largest decline in births, CDC says
(CNN) -- The birth rate for women over 40 in the United States rose between 2007 and 2009. Among every other age group, however, the birth rate fell during the same period, according to a report released by the Centers Disease for Control and Prevention.

According to the study, women between 40 and 44 experienced a 6% increase in birth rate during the time period. There were 9.5 births for every thousand women in that age group in 2007, 10.1 births per thousand in 2009.

Younger mothers had more babies per thousand women during the time period, however, birth rates declined for every age group under 40, according to the study released Thursday.

The study also found that after reaching an all-time high of 4.3 million births in 2007, the number of babies born in the United States dropped 4% to 4.1 million in 2009. A provisional count taken between 2009 and June 2010 indicated a continued fall in births, the CDC said.

Fertility rates also dropped for all major racial groups in the United States during the study period. The largest decline was among Hispanic women, for whom birth rates declined 9 percent between 2007 and 2009.

The decline in births from 2007 to 2009, the report stated, "is relatively small in a historical context compared with the declines in the early 20th century and in the 1960s and early 1970s."

The report was prepared by researchers in the CDC's National Center for Health Statistics, Division of Vital Statistics, Reproductive Statistics Branch.

So according to this, about 1% of women 40-44 will have a child in any given year. If 5% rate of conception were correct, that would mean that 20% of women 40-44 are trying to conceive. I don't think that is true.

[Anonymous]

So according to this, about 1% of women 40-44 will have a child in any given year. If 5% rate of conception were correct, that would mean that 20% of women 40-44 are trying to conceive. I don't think that is true.

Maybe they weren't "trying to conceive" so much as "not doing anything to actively prevent conception." A lot of women think once they reach a certain age they no longer need to worry about protection, and whoops! And of course, women who are actively seeking fertility treatment are in that stat, too.

OP here. Also, can someone tell me more about ovarian reserve testing? Shouldn't this be done first before telling someone you only have a 5% chance of carrying a baby to term? I had first baby at 38 and second at 39. It's so hard to believe that my eggs are not good enough anymore. Clearly, I am in denial about being 42 and what that means with regards to fertility!

Well, maybe a little bit in denial Decline in fertility isn't perfectly linear; it grows much steeper in one's 40s, on average. Your eggs were different at age 39 than they are at 42, even though that doesn't seem so long ago. But if you have a good ovarian reserve, that is absolutely a point in your favor. It means that maybe you have more good eggs than the average woman might at your age. That may balance out the majority of abnormal eggs that most women have at this age.

Honestly, though, unless you're planning to go back to this doctor, who cares about the stats? Just continue having sex during your fertile times and hope for the best!

I am also getting increasingly angry when those rates are quoted by my RE. Oh, really, I am 39? Thanks for the news. Now please explain why I am paying you $$$ if you can't do anything about it.

I understand this anger -- I feel it. But there's only so much that can be done to turn back the clock. (I'm 40, by the way) I feel great, I look young on the outside, but my ovaries are the ovaries of a 40-year-old. I did IVF at 40 and got 11 eggs and thought that was great, but I read about women just a few years younger than me getting 20+ eggs and ending up with blasts frozen and I just wish I had started sooner. Oh well.

[Anonymous]

Anonymous wrote:I understand this anger -- I feel it. But there's only so much that can be done to turn back the clock. (I'm 40, by the way) I feel great, I look young on the outside, but my ovaries are the ovaries of a 40-year-old. I did IVF at 40 and got 11 eggs and thought that was great, but I read about women just a few years younger than me getting 20+ eggs and ending up with blasts frozen and I just wish I had started sooner. Oh well.

I kind of agree with that, but then, if it can't be done, why are they selling me painful treatments that cost tens of thousands of dollars? This is what annoys me. And the more I think about this, the more I think that IVF doesn't really increase my chances at all. I think the chances are pretty solid (and even this 5% conception statistic kind of supports that, if you calculate probabilities) that, at age 40, if you TTC every single cycle on your own, you will have a child within next 3 years.

[Anonymous]

I recently had a baby at 42. When I asked my OB priorto about the likelihood of conception at 42, he said if timed correctly there was a 20 percent each month. I thought that number sounded like a high probability. It took three cycles.

[Anonymous]

I kind of agree with that, but then, if it can't be done, why are they selling me painful treatments that cost tens of thousands of dollars?

I agree with you -- I think that doctors shouldn't do that, to be honest. But then you have patients who, like the OP, are saying "why are you giving me these stats, what are they based on, I don't believe it because of [extenuating circumstance]."

I'm not picking on the OP at all, by the way. She is hardly alone in these feelings. And how many times have we seen posts here from someone who said that they were able to cure their fertility problems with supplements and acupuncture and Eastern medicine and whatever? Everyone wants to believe they're going to be the one who beats the odds. And someone always *does* beat the odds, otherwise the chances of conception after 40 would be zero, and we know that's not true. (Look at the person who posted just before me, as an example.)

I do feel for doctors -- as much as I can feel sorry for a group of gazillionaires -- that they have to walk this line between offering reasonable medical treatment, and yet not offering false hope.. I think it just has to be our job to decide when we're going to walk away, and we can't rely on doctors all the time to tell us when that is. But that's hard when you hear about 45 year olds conceiving, or 42 year olds who conceived in three months, or people who conceived on their 10th IVF, or some story like that.

[Anonymous]

Oh, just to add:

at age 40, if you TTC every single cycle on your own, you will have a child within next 3 years.

I'm not *totally* sure that's correct. Statistics are not my strong suit, let me say that first! But if you're talking about your conception chances over that three year time period, they're going to be higher at age 40 than age 43. It's not an equal chance every month for that 36 months.

[Anonymous]

Anonymous wrote:

I kind of agree with that, but then, if it can't be done, why are they selling me painful treatments that cost tens of thousands of dollars?

I agree with you -- I think that doctors shouldn't do that, to be honest. But then you have patients who, like the OP, are saying "why are you giving me these stats, what are they based on, I don't believe it because of [extenuating circumstance]."

I'm not picking on the OP at all, by the way. She is hardly alone in these feelings. And how many times have we seen posts here from someone who said that they were able to cure their fertility problems with supplements and acupuncture and Eastern medicine and whatever? Everyone wants to believe they're going to be the one who beats the odds. And someone always *does* beat the odds, otherwise the chances of conception after 40 would be zero, and we know that's not true. (Look at the person who posted just before me, as an example.)

I do feel for doctors -- as much as I can feel sorry for a group of gazillionaires -- that they have to walk this line between offering reasonable medical treatment, and yet not offering false hope.. I think it just has to be our job to decide when we're going to walk away, and we can't rely on doctors all the time to tell us when that is. But that's hard when you hear about 45 year olds conceiving, or 42 year olds who conceived in three months, or people who conceived on their 10th IVF, or some story like that.

I think there is a difference between treatment (where IVF can indeed help) and age. I am not sure IVF helps AMAs any more than consistent, timed intercourse. Of course, if your tubes are blocked, then it will help. But I think it's a mistake to do IVF for "unexplained infertility" if you are over 40.

That said, I will do IVF. Not because I think it will help me over and above timed intercourse, but because I am not sure I will be strong enough not to try it 3 years down the road when it will cost much more per chance of success.

[Anonymous]

At 42 your chances are definitely low, but the question you should ask (instead of what the statistics mean) is what you can do about it. Basically, at 42 you are more or less looking at two options: a) luck and b) donor egg. Since donor egg is an option even at much older ages, there's no reason no to give luck a good shot at it. I'd confer with my RE and see when you hit "now or never" for DE and then give luck a shot between then and now. Don't even bother with IVF.