QuestionHello Doctor, I am from Melbourne, Australia. My doctor says I am "only 40" and there is still a good chance of having a baby. I had severe endometriosis removed 3 years ago. Since then I have had 2 chemical pregnancies and a missed miscarriage at 9 weeks. I would like some facts about how likely (%) it is that I will ever hold a baby in my arms? I am not prepared to have fertility treatment, I would like to continute trying naturally. What are my chances doctor? Thank you, Melanie
AnswerHello Melanie from Australia,
Keep in mind that statistics is just a "reflection" of reality but not reality. There are always exceptions. It's purpose is just to give you and idea of the chances. It cannot tell you exactly what will happen.
That being said, you should take comfort in the fact that you have had three pregnancies by natural means. That is better than most 40 or 41 year olds. Most 40 or 41 year olds just don't get pregnant. Statistically, your chances of pregnancy at 41 years old is approximately 0.5-1% per month of trying or slightly less than 10% per year of trying. Your chances of miscarriage are significantly increased, as you have experienced. A "chemical pregnancy" is a form of miscarriage. This is because the "age factor" is describing is the reduction of egg quality with increasing age because those eggs have been with you since you were born. Because of this egg quality, there will be an increased in abnormal embryos which will lead to either non-implantation or miscarriage (and as you know, the ones that make it have an increased risk of genetic abnormalities such as Down's syndrome). Each month you ovulate one egg so you have to hope that it is a good egg that proceeds to forming a normal embryo. This can take time.
The only alternative, which you mentioned you would not consider, is to move to fertility treatment such as IVF where we can recruit 10 or more eggs at a time, thereby increasing the chances of finding a good embryo, and achieving a successful pregnancy. Fertility drugs can be given to you to increase the number of eggs you ovulate at a time, but because we cannot predict how many embryos will be formed and enter in the uterus, we usually will limit the number of eggs ovulated, which in turn reduces the chances again.
The bottom line is that you know that you can get pregnant. You just have to keep trying and hopefully one of these pregnancies will be a good one and lead to a baby in your arms. Persistence and faith is the key.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
