Tubal damageThis is still the biggest single indicator for IVF. Indeed, it is sometimes argued that a reason for the growth in demand is because of the increase in tubal damage. Some doctors see surgery as a better option, arguing that it offers the prospect of a permanent cure for the infertility and repeated natural pregnancies. However, older women often simply cannot afford the time needed to have and recover from surgery and then see if it has worked: even if surgery does open the tubes, they may still not function properly. Others, who may already have had many years of more conventional treatment including bouts of hospitalisation and repeated pregnancy losses, may find tubal surgery too invasive and therefore unacceptable.
Any woman having IVF needs to accept there is a risk of ectopic pregnancy where the pregnancy develops outside the uterus. Some statistics show that the chances are higher if the woman has open fallopian tubes, although why this happens is not known.
Ovarian factors, including ageRapid and controversial progress is being made in IVF for the treatment of older women. Age is still one of the biggest factors in determining its success and most treatment centres, especially those in the National Health Service, have strict age limits for the women whom they will accept. However, two developments are changing this. One is egg donation; the other involves experimental and extensive hormonal therapy for older women. Some women who have had a premature menopause, have been successfully treated using donated eggs, and women with polycystic ovary syndrome have also had children after IVF.
With the rapid strides in medical science, it is likely that in years to come more fertility problems can be resolved through IVF. Factors which now appear to exclude couples from treatment will be irrelevant. The issue then will not be whether the couple can be treated, but whether - once everything is taken into account - it is the right course of action for them. It can be hard for a childless couple to turn down the opportunity to have a baby of their own and they can be very vulnerable to offers of help. What they need is to weigh up the financial, physical and emotional costs of treatment against the likely success rates.
