Over 40 and few eggs left: case of my friend Elena B.
The first email I had a look at this morning was from my dear Itallian friend Elena (name changed). I know that she’s been trying to get pregnant for about a year now, and with each new email from her a part of me is hoping to hear good news.
Unfortunately, the news this morning was not good.
Elena and her new husband have been to a fertility clinic and were already confronted with the idea of considering entering the egg donation program.
Basically, what happened to a friend of mine was reflecting the reality of most other women of that age who have infertility issues: they still have some eggs left, but they are no longer able to start a new life.
Here is what I told her:
Yes, egg donation is a great opportunity, and all women who are nowadays facing infertility issues should feel happy every day and be grateful that programs like egg donation exist.
Generations before could not have dreamed of such possibilities.
Egg donation can save a relationship, women’s mental health, make women into a mother, and provide a whole lot of meaning to a life even when all other options fail.
But they need to fail first.
Before that happens, here is what I think that each woman can and should do:
At 40 years of age, an average woman still has some eggs left (about 10% of the women are the exception to this rule and their ovaries become depleted earlier).
Therefore, at 40 and above, there are still eggs to work with and the possibility to have your own child should not be abandoned too easily! Please read this post on how I learned in my coaching practice that US-women are advised earlier to try egg donation and why.
Results will not occur overnight and a reasonable time frame needs to be allowed. So take half a year at least and try to improve the quality of your own eggs as much as possible and utilize them to get pregnant, either naturally or through IVF.
Many women are not aware of the fact that the female body can sustain pregnancy even in advanced age (mid 40s or even later is no problem for a healthy woman), only that there will not be any more of your own eggs left at that time.
Pregnancy does not seem to be the issue; ovulation and fertilization do.
In my opinion, only AFTER one ovarian reserve is completely gone comes the point when donor eggs come in. But, before that happens, a woman can and should direct her efforts in improving her own ovarian reserve.
Whether you will enter an egg donation program at 41, or 45, or even later might not make a big difference in terms of positive outcome. IVF treatments with donor eggs have success rates similar to those in young healthy women (about 30%), so why not play your biological cards first?
When we talk, Elena is calm and smiling at my rhetorical bursts. I missed that while writing emails back and forth.
I first suggested she start improving her eggs by taking DHEA. In otherwise healthy women, who have no other problems but their advanced reproductive age, DHEA is the first option to consider.
If athletes are not shy to take a lot of DHEA for years if only to get a slightly better muscle definition, why would you be so reluctant about 50-75mg a day when it comes to becoming a genetic parent?
I repeatedly get to hear concerns about DHEA side effects (Is DHEA a hormone? A friend of mine was taking only 5mg and actually got fewer eggs in her IVF? My doctor does not believe in DHEA. I’ve read in a discussion forum it is not possible to improve the egg quality, etc.)
Variations are endless (especially when talking to German women, there are strong cultural differences on these matters).
You know what?
First, if you don’t feel comfortable taking DHEA, don’t take it. It is your body and it is OK to decide how to treat it.
Second, if you have issues related to testosterone, PCOS, thyroid, or ANY other serious medical condition, don’t take DHEA. Don’t take any other supplement, hormone, or whatever chemical in high concentration before talking to your doctor first.
To come back to the topic of DHEA side effects – yes, side effects of DHEA do exist sometimes.
During the months that I was taking DHEA, my skin looked better (verified by objective third parties who had not seen me in a long time) and several wrinkles had disappeared from my face.
Next, I was not getting sick as often as in years past (but this might relate to a slightly changed diet and a few other supplements I was taking).
Finally, I never had to push myself even slightly in the direction of having intercourse, in spite of baby-making stress, which already started affecting our relationship quality time. Please don’t tell me you don’t know this issue; taking DHEA for that alone is not worth it.
So what else did I recommend to my friend Elena to take?
The usual suspects:
Vitamin D (in this post here you’ll find more on vitamin D and fertility , including dosages, scientific citations etc).
CoQ10 (please read how CoQ10 improves egg energy status)
Omega 3 (it’s not just omega 3, but its ratio to omega 6 that counts, please follow this post).
To conclude, there really is no reason to give up too early, or too easily! As long as there are eggs, there is hope, and one can work on improving egg quality. Think about it like preparing your eggs to run a marathon – at the beginning it will be difficult to get them up and running in the morning, but after some months they will be waking up by themselves and want to get going in the fresh air (in their case ovulating).
Just start and your body will tell you what to do next.
Disclaimer: This information is for educational purposes only, and is in no way intended to be personal medical advice. Every woman is different her medical needs, so please ask your physician about any health guidelines seen on this website.