Grandmother uses IVF to have more children

Mrs. Lan and her husband went to the Center for Reproductive Support, Tam Anh General Hospital, Hanoi (IVF Tam Anh), for in vitro fertilization. The doctor explained the risks of having a child at this age, such as having to ask for eggs, embryos with high risk of malformations, difficult pregnancy and pregnancy maintenance…, but they still decided to have another child.

“I don’t mind having another child even though I’m already a grandmother,” Ms. Lan told the doctor, adding that her daughter also supported the idea. However, relatives objected, worrying that “the father will be old and the child will be weak” or “the child will have to carry an uncle (aunt) in the future.”

The test showed that Ms. Lan’s AMH ovarian reserve index was only 0.03 ng/ml, meaning very few eggs, low fertility. After three cycles of mild ovarian stimulation, the doctor only obtained two dominant follicles. Only one egg was qualified for intracytoplasmic sperm injection (ICSI), creating a single embryo. Fortunately, preimplantation genetic testing (PGT) to screen the embryo did not detect any chromosomal abnormalities.

The embryos were frozen in an international standard LAB and monitored using a Time-lapse incubator system while the doctor prepared Ms. Lan’s lining for embryo transfer into the uterus. Doctors determined that if the embryo transfer was unsuccessful, Ms. Lan would no longer have a chance to have a child using her own eggs.

At the age of 48, Ms. Lan’s uterine lining was very thin. After 4 cycles of treatment monitoring, she was eligible to receive embryos. In June 2023, she had a single embryo transferred into the uterine cavity, after injecting autologous platelet-rich plasma to improve the thickness of the lining and testing to ensure the embryo transfer was at the right time for the endometrium to receive.

Ms. Lan became pregnant but during her pregnancy she suffered two threatened miscarriages, high blood pressure, and gestational diabetes. Obstetricians and endocrinologists closely managed her pregnancy. At week 36, she showed signs of generalized edema and high blood pressure due to preeclampsia, and had an emergency cesarean section to deliver a 2.5 kg baby girl.

“It’s been almost two years but it feels like 20 years,” Lan said, describing her difficult experience of IVF and pregnancy.

Associate Professor, Doctor, Doctor Le Hoang, Director of IVF Tam Anh, said that the need to have more children among middle-aged people tends to increase. At the center, the rate of women aged 40-50 coming for examination and consultation on having children has increased by 42% compared to two years ago, accounting for 20% of patients receiving assisted reproductive treatment. Of these, 50% of cases have not had their first child and 50% have the need to have more children.

According to studies around the world, the pregnancy rate drops from 55% in women under 30 years old to 10% in women over 40 years old, and less than 1% in women over 45 years old. In women over 45 years old, the miscarriage rate is more than 50% even when they have successfully conceived using their own eggs.

“Older women often have careers, enough material conditions and time, but getting pregnant, maintaining pregnancy and giving birth become difficult,” said Dr. Hoang, adding that fortunately, assisted reproductive methods, especially in vitro fertilization, have developed rapidly to help them realize their dream of becoming mothers.

According to Dr. Hoang, at IVF Tam Anh, there are cases over 47 years old, even after menopause, who can still get pregnant but thanks to donated eggs. Ms. Lan is among the few cases of people in their 50s who have successfully given birth to a child using her own eggs.

The older the mother, the higher the chance of giving birth to a child with chromosomal disorders such as Down syndrome, Edwards syndrome, etc. Research shows that for a 25-year-old mother, the rate of giving birth to a child with Down syndrome is only 1/1,250, but for a mother over 45, the rate is 1/30.

Pregnancy at an older age also increases the risk of diabetes, high blood pressure, pre-eclampsia, eclampsia, etc. Pregnancy can easily aggravate chronic diseases (if any), increasing the risk of premature birth and miscarriage. The fetus is at risk of birth defects such as heart, lung, musculoskeletal defects, slow fetal development, low birth weight, stillbirth, etc.

Dr. Hoang advises older women who intend to have children to be aware of and consider the risks to make the right decision. They need to prepare mentally, physically, and financially and seek treatment as soon as possible to limit risks and increase the success rate.