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For older woman with a persistently poor ovarian response, many options have been explored to try to improve the number of eggs produced. This includes using supplemental growth hormone; and the newer recombinant gonadotropins.. However, the results of these have been disappointing, and the fact remains that we do not have an effective method of helping poor ovarian responders.
A very effective option for older woman whose own eggs do not grow well is that of using donor eggs or donor embryos. However, this is obviously a very sensitive emotional issue, and each couple needs to make their own decision. While using donor eggs and embryos does dramatically improve pregnancy rates, it is often an option many couples find hard to come to terms with. It is also becoming increasingly difficult to find suitable egg donors. While egg donation has become commercialised in the USA, this has raised a lot of hue and cry, because critics feel that young women are being enticed to "sell their eggs".
Finding altruistic egg donors is an uphill task for most women, because they are often very reluctant to ask for help, since this would involve telling others about their problem. Support groups like NEEDS (National Egg and Embryo Donation Society) in the UK have been very helpful in motivating voluntary egg donors by creating public awareness of the need for healthy young women to donate their eggs. Clinics have also adopted various approaches to help resolve this problem . Some large clinics run successful anonymous egg donation programs; others use known egg donors (either paid or unpaid); and others encourage their patients to share their supernumerary eggs (often for a financial consideration) with other patients.
An exciting option for the future may be that of egg banking. A lot of research is being focussed on developing more efficient methods to cryopreserve and store eggs. If this becomes clinically practicable, then it may become possible to freeze a woman's eggs or ovarian tissue when she is young, and store these for her in liquid nitrogen at -196 C, so that she can use her own "young" eggs in the future, whenever she decides to start her family!
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
