Until what age can IVF be done?
Currently, the age for the IVF program is not regulated in any way by law, that is, formally, a woman at any age can apply to an assisted reproductive technology (ART) clinic for medical help. However, her age and health condition will influence the choice of treatment program. Much depends on the ovarian reserve of the body. The number of eggs is not infinite – after 35 years, their number is steadily declining. So, depending on the age and ovarian reserve of the patient, there may be indications for an oocyte donation program. Indications for the use of oocyte donation (hereinafter referred to as DO) are:
- absence of oocytes due to natural menopause, ovarian failure syndrome, condition after ovariectomy, radio or chemotherapy, genetic diseases;
- unsuccessful repeated attempts to transfer embryos with an insufficient response of the ovaries to stimulation, repeated receipt of poor quality embryos, the transfer of which does not lead to pregnancy.
In this case, another woman aged 18 to 35, physically and mentally healthy, who has undergone a medical genetic examination, acts as an oocyte donor. Oocyte donors can be either non-anonymous or anonymous. Thus, the patient, in the absence of contraindications to pregnancy and childbirth, bears the child on her own. If the patient has indications for the use of the surrogate motherhood program, this type of treatment will be additionally offered.
Indications for IVF
Medical indications are:
- absence of a uterus;
- deformation of the cavity or cervix, when correction is impossible or has no effect;
- pathology of the endometrium (synechia, obliteration of the uterine cavity, endometrial atrophy), when correction is impossible or has no effect;
- diseases (conditions) included in the list of contraindications;
- no pregnancy after repeated embryo transfer attempts (three or more attempts with good quality embryo transfer);
- habitual miscarriage, not associated with a genetic pathology.
Is pregnancy possible after the removal of the fallopian tubes?
The fallopian tubes are the so-called “oviducts” – i.e. after ovulation, the egg enters the fallopian tube and, thanks to the work of the epithelium of the inner lining of the fallopian tube, moves into the uterine cavity. Spermatozoa enter the uterine cavity through the cervix, and then through the mouth of the fallopian tube into the lumen of the tube, where they reach the egg for fertilization. After fertilization, the crushing embryo, all along the same fallopian tube, moves into the uterine cavity. Thus, the presence of passable fallopian tubes is one of the conditions for the onset of independent pregnancy. In the absence of fallopian tubes, there is no connection between the pelvic cavity and the uterine cavity. Patients with removed fallopian tubes can become pregnant only with the use of ART methods.
Can you get pregnant if you are HIV positive?
HIV infection in discordant partners (when one partner is HIV-negative, he does not have HIV, and the other is HIV-positive), regardless of fertility status, is an indication for an IVF program. When one of the partners is HIV-infected, natural conception may not be possible due to the clinical situation where the use of barrier contraception is recommended to prevent transmission of HIV to a healthy partner. HIV infection is not a contraindication to providing medical care to patients using ART and AI.
The choice of a program for a safe (including for the unborn child) option for achieving pregnancy should be carried out by an obstetrician-gynecologist of the ART Center together with an infectious disease doctor with the obligatory informing patients about the possible risks of HIV transmission. Examination of patients and carrying out ART or AI programs is possible only if there is a conclusion from the Center for the Prevention and Control of AIDS and Infectious Diseases.
The conclusion should contain a brief extract from the medical history and diagnosis, the results of tests for HIV infection, an indication of the absence of contraindications and special conditions (for example, parallel antiretroviral therapy) for the provision of this type of medical care and pregnancy.