New Study: A Poor Response to IVF May Predict Future Health Problems

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If you tried in-vitro fertilization  (IVF) or got pregnant through IVF, you will remember the part of IVF when you were given a hormone medication to stimulate egg production in your ovaries. About 36 hours after stimulation ends, you had eggs removed from your ovaries. Getting more eggs improves your chance of getting a successful embryo for implantation. A normal response is a production of at least eight eggs. If you produced five or fewer eggs, it is considered low ovarian reserve and a warning for early ovarian aging.

What Is Early Ovarian Aging?

Unlike men who can produce an almost unlimited number of sperm well into older age, women have a limited number of egg follicles that will produce and egg. Once the follicles are used up, there are no more eggs. This usually occurs at the age of menopause. It can occur earlier in some women than others, called early menopause.

Early ovarian aging is when you are getting close to the end of your follicles. Previous studies have found that women who have menopause before age 40 may also have early aging of their heart and blood vessels. In fact, a huge study done in 2019 found that women who undergo menopause before age 40 may have double the risk for cardiovascular heart disease (CVD) than women with later menopause.

The New Study

Now, the first large study to look at the link between egg production during IVF and later-life health risks warns that early ovarian aging may be a warning for accelerated aging in general, especially for CVD and osteoporosis. The study was done by researchers at Aarhus University in Denmark and presented at the 2020 meeting of the European Society of Human Reproduction and Embryology.

The researchers reviewed the medical records of almost 20,000 women under age 37 who had a first-cycle IVF in Denmark between 1995 and 2014. The study looked at about 6 years of health records for the women in the study after their IVF. They included any cause of death (all-cause mortality) along with reports of CVD, osteoporosis, type 2 diabetes, and cancer. These were the key findings:

  • There were 1,234 women with early ovarian aging (five or less eggs).
  • There were 18,614 women with normal ovarian response (eight or more eggs).
  • Women with early ovarian aging had a 26 percent greater risk for developing a long-term age-related disease.
  • The most significant risks for women with early ovarian aging were a 39 percent higher risk for CVD and a greater than 50 percent higher risk for osteoporosis.

 The researchers conclude that a low response to ovarian stimulation should be a warning sign that triggers prevention counselling for women, especially for CVD and osteoporosis. This could include lifestyle changes like a diet and exercise or hormone replacement therapy.

If you had a low response to egg stimulation during IVF, it doesn’t mean that you are doomed to earlier CVD or osteoporosis, but it may mean that you are at higher risk. Think of it as an early warning. The good news is that both of these conditions may be prevented with lifestyle changes that you can start now. Talk to your doctor about what you can do to reduce your risk of future age-related health problems.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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