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Unfortunately, there are no treatments available that can "turn back the clock" on a woman's ovaries. Many physicians use fertility medications to try to increase the chance of pregnancy. Fertility medications increase the number of eggs that develop in a given month, and enhance the chance that at least one of them might be able to be fertilized and develop into a pregnancy. Although fertility medications seem to offer some hope, the pregnancy rates are generally poor.
The only consistently successful method to improve pregnancy rates in women with age-related (or "elevated FSH-related") infertility is egg donation. Some indications for egg donation include advanced age, persistently high FSH levels at any age, poor response to fertility medications at any age, and poor quality embryos at in vitro fertilization.
- Fertility declines significantly after age 40.
- Miscarriage rates are higher for older women.
- A decreased ovarian reserve suggests a poor prognosis for fertility.
- In women over 35, a fertility evaluation should be given after 6 months of unprotected intercourse.
- Aggressive treatment may be indicated to capitalize on the "window" of fertility.
- Oocyte donation is most likely the best option for the woman over 40 who has an elevated basal FSH level.
Prepared by: David Barad, M.D., Director The Fertility & Hormone Center at Dobbs Ferry, Dobbs Ferry, NY