What are the chances of aneuploidy in embryos via In Vitro Fertilization (IVF) at 44 years old and how many eggs are needed to retrieve to get at least one euploid embryo?

Aneuploidy Rates and Oocyte Requirements for IVF at Age 44

At age 44, the chance of obtaining a euploid embryo through IVF is extremely low (approximately 10-11%), and you would need to retrieve approximately 10-20 eggs to have a reasonable chance of obtaining one euploid embryo.

Aneuploidy Rates at Age 44

• The rate of embryonic aneuploidy increases dramatically with maternal age, with women at age 44 experiencing approximately 88-90% aneuploidy rates in their embryos 1, 2
• In women aged 44.0-44.9 years, the delivery rate per IVF cycle is only about 10.6%, dropping to 2.6% in women aged 45.0-45.9 years 2
• For women aged 44 and older, the cumulative live birth rate is extremely low at approximately 1.2%, regardless of the number of oocytes retrieved 1

Number of Eggs Needed for One Euploid Embryo

• Based on the 10-11% euploidy rate at age 44, approximately 9-10 blastocysts would be needed to obtain one euploid embryo 2
• Since not all retrieved eggs develop into blastocysts (typically 30-50% blastulation rate in advanced maternal age), you would need to retrieve approximately 18-30 eggs to have a reasonable chance of one euploid embryo 1, 3
• A study of women aged 44-47 found that only 14% of IVF cycles resulted in euploid blastocysts, with an overall euploidy rate of just 11.8% 2

Factors Affecting Success Rates

• Ovarian reserve (measured by AMH levels) and female age are the two most important predictors of obtaining euploid embryos 3
• The probability of having at least one euploid embryo decreases significantly with age, particularly after age 40 3
• Women over age 43 have extremely limited odds of success with their own eggs, regardless of the number of oocytes retrieved 1

Preimplantation Genetic Testing Considerations

• Preimplantation genetic testing for aneuploidy (PGT-A) can help identify euploid embryos but has technical limitations including potential sequencing errors and false positives 4
• The American College of Obstetricians and Gynecologists notes that PGT-A has success rates of only approximately 50-60% of women achieving pregnancy after the procedure 4
• Despite limitations, PGT-A may be particularly valuable for women of advanced maternal age to reduce miscarriage risk and improve delivery rates per transfer 2

Clinical Implications

• Women aged 44 should be extensively counseled about their very low odds of success with IVF using their own eggs 2
• The delivery rate per embryo transfer in women aged 44 who have euploid embryos can still be relatively good (57.1%), but the challenge is obtaining those euploid embryos 2
• No euploid blastocysts were found in patients older than 45.0 years in one multicenter study, suggesting a clear biological threshold 2

Practical Recommendations

• For women aged 44 seeking IVF, multiple stimulation cycles may be needed to accumulate enough eggs for a reasonable chance at a euploid embryo 1, 5
• Even after a first IVF cycle resulting in only aneuploid embryos, younger women (under 42) may still have favorable prognosis in subsequent cycles, but this benefit diminishes significantly at age 44 and beyond 5
• Patients should be counseled about the significant financial and emotional costs of pursuing multiple IVF cycles at advanced maternal age, given the low probability of success 4, 2