When is it too late? IVF over 45 – how to choose the right clinic

The answer is (and we’re sorry) – it depends! Cut-off points and age caps vary from clinic to clinic and case to case, but one of the big factors is where in the world you’re looking to have IVF. Yes, many women absolutely can have IVF at age 45, and well into their 40s. The question is, where is their go-to? 

What’s the maximum age for IVF in the UK?

In the UK, private clinics often cap assisted reproductive technology (ART) at age 43-45, and the NHS cap is usually age 42-43. 

Clinics in Europe, however, are increasingly set up to offer IVF and treatment support to women aged 45 and over. Advances in egg donation techniques and cutting-edge, bespoke patient care plans mean that age 45, while an important detail, isn’t a hard stop on the fertility journey. 

If you’re prepping and making decisions on IVF over 45, the first thing to set in place is the team supporting you. From your clinic and IVF consultant to any integrated therapies – read up on acupuncture for preconception in your forties, for more tips – having near-to-absolute trust in your team provides an expert support network, and saves that essential aspect – time. 

For IVF over age 45, Procriar is a top destination clinic in Europe right now. Read up on their progressive approach, plus our deep-dive chat covering open ID egg donation, for an idea of the Porto-based team’s expertise and patient-first practice. 

Making the most of their experience – the team are led by revered reproductive medicine specialist Dr Joana Mesquita Guimarães – we wanted to know, 

• IVF over 45 – do clinics offer it and how do we get started? 
• can we have IVF over 45 with our own eggs? 
• what’s the maximum age for IVF? 
• what should we know about success rates?
• any top tips for positive action we can take, right now? 

Over to Procriar, for answers, factors to consider and next steps, before continuing your fertility journey. 

IVF over 45 – your questions answered

What are the regulations/guidance around having IVF over 45?

In Portugal, there are no specific guidelines or regulations on this topic. 

Portuguese law allows us to treat patients up to age 49 + 364 days, so there’s not really a barrier at the age of 45. From a medical standpoint at Procriar, patient safety is key. We’ll only ever treat when it’s safe to do so, and when it makes sense medically. 

This means we first need to assess whether it’s safe to have a pregnancy at the age you’re at – whether that’s age 39, 45 or 48, for example – and from there, we need to work out what’s possible. In this case, we’re usually deciding with the patient between the likelihood of success with her own eggs, or via donation.

What kind of pre-IVF testing is required for age 45+?

It’s important for us to start with an ovarian reserve evaluation, as this is key for us to understand whether treatment with your own eggs is possible, and also to define the best ovarian stimulation strategy.

It’s also extremely important to confirm if pregnancy would be safe – so we need to: 

• check the uterus
• do a pap smear
• and a mammogram

All of these, among other general tests, will be part of our pre-IVF testing plan for people aged 45 and over.

How specific will my protocol be, at age 45?

All protocols really should be specific. ‘Off-the-shelf’ treatment plans often struggle to build in the kind of thorough evaluations and options required for IVF, especially at age 45 and over.

At Procriar, we work on the basis that older patients often need different ovarian stimulation approaches. For example, in some cases we might propose patients do dual stimulation protocols, in order to accumulate eggs before moving on with fertilisation.

The protocols for egg donation treatments are also very variable and depend on a lot of medical factors and each patient’s specific profile, history and fertility issues.

Bottom line, as a clinic treating all sorts of patients, including people aged 45 and over, we always tailor treatment to individual patients. We’re not a one-size-fits-all clinic, and proud of it!

What about genetic testing? Any other tech or approaches we should ask about?

Above the age of 45, we definitely advise PGT-A testing to all patients, as the risk of aneuploidies is significantly increased.

Your clinic should always be honest with you, and the choice between trying with your own eggs, or going for egg donation, is a conversation that needs to be had. It’s tightly bound up with very personal decisions and preferences, but is often the best available option. 

Whatever you choose, we’ll support you across the journey, from start to parenthood.

Can I use my own eggs if I’m over 45?

Yes, as long as your ovaries are still functioning and you make an informed decision, being completely aware of the associated probabilities of success.

If success looks unlikely, the team here are primed to help you navigate this difficult part of the journey. And, if and when you’re ready to discuss next steps and look at other options, our IVF with donor eggs programmes are a key part of why patients put their trust, time and again, in Procriar. 

How many IVF cycles do you recommend for women over 45?

For IVF with your own eggs, we’ll normally try up to three cycles.

What could success rates look like for me? (own eggs vs donor eggs)

IVF with your own eggs at the age of 45 is associated with a 2-3% success rate – but it can even be impossible, as it depends on the patient’s ovarian reserve. Unfortunately, nature is really not on our side here!

However, with egg donation we’d expect values between 60-70%, with cumulative pregnancy rates (meaning pregnancy after at least 3 embryo transfers with egg donation) going easily above 90%. 

What else should I look for in a clinic?

The most important factor is honesty and transparency – as sometimes, especially while trying with the patient’s own eggs, it’s necessary to give bad news, and openly assess other possibilities.

From a more clinical standpoint, it’s key that the clinic has a very good PGT-A programme. And, if you’re planning to try with donor eggs, it will be crucial to choose a clinic with a very good egg donation programme – one which allows you to go for genetic matching with your future donor. 

It’s also very important to choose a clinic with open-ID donors, with thorough profiles you can easily access and work through. 

Keen to get started? Connect with the Procriar team for more answers to specific questions, education and world-leading treatment. 

And, good luck from all of us at Team TRB. We’re rooting for you.