Many would argue that we’re already at crisis point when it comes to the provision of NHS funded fertility treatment in the UK.
In 2016, over 50,000 women underwent IVF treatment and each year this figure increases. As the trend towards couples marrying and having families later in life is also on the rise – the average age for marriage has risen from 28 in 1972 to 36 in 2012 (Office for National Statistics) – it’s clear that IVF demand is likely to maintain an upward curve.
There is a growing number of fertility clinics offering ‘Mini IVF’ to older women, whereby the woman pays to freeze embryos in the hope of transferring a good quality embryo at a later date. Some clinics will carry out this procedure up to the age of 50, advocating successful procedures of multiple births to women in their mid-40s.
With NHS resources already stretched, the access to free fertility treatment has become a postcode lottery in the UK. Currently only 40% of the 50,000 are undergoing NHS funded treatment and only 18% of NHS funded clinics that provide IVF are offering the minimum three cycles.
In addition, the supply of eggs and sperm in the UK is dwindling. The UK are one of a few countries that don’t legislate for donor anonymity. Many would-be donors are therefore unwilling to take the risk.
The result is the majority of couples have little choice but to seek private treatment, but many simply can’t afford it. The UK currently has some of the highest IVF treatment prices in Europe, in some cases more than 50% more expensive than in Spain, Greece, or Eastern Europe.
This is encouraging an unprecedented number of couples to seek treatment in Europe where a combination of low treatment costs, high success rates and access to new treatments are on offer.
Women who are 40 and over are faced with the highest IVF failure rates and therefore on average have to undergo more cycles than younger women. The prospect of a more affordable IVF option abroad is a particularly attractive one. But finding the right clinic can be a daunting prospect, particularly one that offers specialist treatment and higher success rates for older women.
The team at Fertility Clinics Abroad have made the job just a little easier with their five steps to success for the over 40s.
STEP 1 – Choosing the right treatment
Deciding on the right treatment is the first and most critical choice in your fertility journey. As a first port of call, always seek advice from your local GP and/or NHS fertility specialist. Desktop research is also a quick and affordable way to access tons of information. There are plenty of resources out there such as Fertility Network UK or check out the forums on Mums.net or Fertility Friends. They’re a friendly bunch and always willing to answer your questions and share their experiences. Our website also features a list of European Clinics which may be useful during your search
In general, the majority of women over 40 opt for donor egg treatment which provides higher success rates than traditional IVF treatment. Donor eggs are typically provided by women under the age of 35, where there are fewer chromosomal abnormalities and therefore higher success rates.
STEP 2 – Which clinic?
If this is the treatment you have chosen, look for clinics that perform a high number of donor egg cycles per year. This is a good indicator that they have experience treating older women. A clinic that performs a lot of donor egg cycles is also likely to have a big donor database which is an advantage when looking for a good match. A clinic should always spend time discussing matching with you – the sophistication of matching is often down to the size and resources of the clinic in question. If it’s particularly important to you, it may be worth spending a little more on larger clinics that have a dedicated matching team.
When choosing a clinic, always ask for their success rate statistics. Most clinics have to or voluntarily submit this information to their country’s regulatory body, so it should be readily available. Be wary of clinics that publish high pregnancy rates for women over 40. For IVF treatment, the pregnancy outcomes are poorer for this age group.
High pregnancy rates may also be an indication that the clinic may be transferring 3 or more embryos at a time, which can result in a multiple pregnancy. This can cause serious problems for mother and baby and should be avoided. Understanding statistics is about reading between the lines and always seek advice from a professional if you’re unsure.
N.B There are often restrictions to the number of embryo transfers and these vary from one country to the next.
STEP 3 – Monitor those embryos
If possible, look for clinics that offer embryo monitoring and preimplantation genetic screening or PGS. Embryo monitoring allows the embryologist to closely monitor a patient’s embryo as they develop in the incubator. This is important because it can tell them which embryos are not dividing properly and achieving their developmental milestones. For women over 40 who choose to have IVF treatment using their own eggs, embryos are more likely to have genetic abnormalities than a younger woman and so monitoring helps the embryologist select the best ones for transfer. PGS is a process whereby the developing embryo is checked for genetic abnormalities such as Down’s Syndrome – embryos from women over 40 are at a higher risk of these generic abnormalities.
STEP 4 – Don’t take unnecessary risks
It’s important to consider the financial and personal risks of IVF treatment. With this in mind, it’s worth having a look for clinics that offer a ‘shared risk programme’ to mitigate possible failures. This is more common for donor egg treatment. For example, some may allow you to pay for two cycles, and if they don’t work, offer the third round for free. At the very least this could save you some money.
Having surplus embryos which can be frozen is a bonus – but check to see if freezing them is included in your treatment price otherwise you will have to be prepared to cover this cost. Having frozen embryos means that you can go back if you want a sibling for your child, or if you were unsuccessful first time, you could go back just for a frozen embryo transfer which removes the reliance on synchronising with a donor.
STEP 5 – Stay healthy
It is important to be fit and healthy before your trip – make sure you stick to a healthy, balanced diet, take regular exercise and find the time to relax to keep your stress levels at a minimum. The healthier you are, the higher your chances of success – also make sure you have a mammogram done and get your blood pressure checked before you embark for your treatment. Some clinics may insist on seeing recent mammograms or indeed may do them at the clinic if they have the facilities. Similarly, good aftercare is paramount.
Women over 35 are at a higher risk of developing diabetes and high blood pressure during pregnancy and so it is important that you are monitored closely throughout your pregnancy.
STEP 6 – Be Zen
It’s important to point out that there are many women of 40 or over that go on to have successful pregnancies without any problems at all – understanding the risks are important, but don’t let scaremongering put you off from achieving your dream. If you plan well, stay healthy and make sensible choices you have every chance of going on to have a happy and successful pregnancy. Good luck on your fertility journey!
Check list:
- DO YOUR RESEARCH! Seek advice from your GP, do plenty of desktop research, consult with friends/contacts who have been abroad for treatment.
- SEEK OVER 40s SPECIALISTS: Find clinics who specialise in IVF for over 40s or who offer high number of donor egg cycles per year.
- UNDERSTAND SUCCESS RATES: Take time to understand what success really means – dig deep and question everything.
- EMBRYO MONITORING: Don’t forget embryo monitoring – it will increase your chances of success.
- MANAGE RISK: Find clinics that offer shared risk programmes to reduce risk/cost of failure.
- SEEK HIDDEN COSTS: Check for hidden costs – is embryo freezing part of the price?
- BE HEALTHY: Take regular exercise, have a healthy, balanced diet, reduce stress.
- STAY POSITIVE: A positive mental attitude goes a long way to helping you get through the challenges ahead.
