Women face hidden fertility ceiling despite donor eggs

New Delhi, India Jul 7, 2026 ALN: Older women face a lower chance of fertility treatment working, even when using young donor eggs - with a marked drop-off from around the age of 49, new research suggests.

In recent years, advances in reproductive technologies have provided hope to many women who wish to conceive later in life. The use of donor eggs has become a common practice, especially for older women who may struggle with fertility issues. However, a new study involving 1,774 women has brought to light significant findings that challenge the prevailing notion that donor eggs can fully "reset" the reproductive clock for older women. The research indicates that while donor eggs can improve chances of conception, age-related factors still play a crucial role in the success of fertility treatments.

Experts have noted that women aged 49 and over face a significantly higher risk of miscarriage—double that of women aged 35 to 40—and are less likely to achieve pregnancy overall. This alarming statistic raises questions about the biological processes at play, particularly concerning the endometrium, or womb lining, which is essential for embryo implantation and growth.

Researchers believe that age-related changes in the womb lining may be responsible for these lower success rates and increased risks. The study found that while the thickness of the endometrium was similar across different age groups, the quality or condition of the lining declined with age. This suggests that older women may face additional hurdles beyond just the age of the eggs used in fertility treatments.

The lead researcher, Dr. Beatrice Crestani, from an assisted reproduction medical institute in Italy, emphasized that reproductive ageing has traditionally been viewed as an issue related solely to the ovaries. The assumption has been that replacing older eggs with younger donor eggs could effectively "reset" the reproductive clock. However, Dr. Crestani's findings indicate a more complex picture, where the health of the womb plays an equally important role in the success of fertility treatments.

In the study, women in their mid to late 30s had a 54% chance of achieving pregnancy through donor eggs and in vitro fertilization (IVF); this percentage dropped to around 43% for women aged 49 and older. Furthermore, live birth rates fell significantly from 46% to 32%, while miscarriage rates increased from 24% to 38%. These statistics underscore the importance of understanding the biological limitations that older women face, even when utilizing the best available reproductive technologies.

Despite these challenges, Dr. Crestani reassured that the findings should not deter women from exploring donor-egg treatment options. She noted that success rates remain meaningful even at advanced ages. However, she cautioned that patients should be made aware of the limitations imposed by reproductive ageing, especially for those over the age of 49.

The study also revealed that for women aged 35-40 who transferred all available embryos, the live birth rate was approximately 80%. In contrast, this rate was significantly lower at 62.5% for women aged 49 or older. These findings highlight the importance of age-related factors in the context of fertility treatments and the potential implications for women considering pregnancy later in life.

One individual who has shared her experience with fertility treatments is TV soap expert Sharon Marshall. After undergoing six years of IVF attempts in her 40s, Marshall successfully gave birth to her daughter, Betsey, at the age of 46. Reflecting on her journey, she expressed the emotional toll that the process took on her, describing feelings of illness, depression, and a loss of autonomy over her body. Marshall's experience serves as a poignant reminder of the challenges many women face when trying to conceive later in life.

Marshall emphasized the importance of transparency regarding the difficulties older women may encounter when attempting to conceive. She noted that societal narratives often celebrate celebrity pregnancies in later years, but fail to acknowledge the struggles and sacrifices that accompany such journeys. Her story highlights the need for open discussions about the realities of fertility treatments and the potential risks involved.

Experts in the field have reiterated that the health of the womb and ovaries can vary significantly from woman to woman. There is currently no legal upper age limit for IVF in the UK, which sets it apart from some European countries, such as Greece, that impose age restrictions. In the UK, women up to the age of 36 are eligible to donate or share their eggs, while guidelines recommend that women up to the age of 40 should be offered three cycles of IVF, and women up to 42 should receive one cycle. However, patients utilizing donor eggs often have to self-fund this aspect of the treatment, which can add financial strain to an already challenging process.

Additionally, it's important to note that individuals conceived using donated sperm, eggs, or embryos from registered donors in the UK after April 1, 2005, have the right to request identifying information about their biological donor parent upon turning 18. This legal framework aims to provide transparency and support for individuals conceived through assisted reproduction.

The findings from this study are being presented at the European Society of Human Reproduction and Embryology (ESHRE) and have been published in a medical journal. Commenting on the research, Prof. Borut Kovacic, Chair-elect of ESHRE, highlighted the ongoing efforts to understand the interactions between the implanting embryo and the womb lining. While this study identifies a threshold age associated with declining uterine function, it also serves as a foundation for future research aimed at identifying biomarkers of uterine ageing.

Dr. Ippokratis Sarris, Chair-elect of the British Fertility Society, has called for further research in this area. He noted that pregnancies for older women can carry additional risks, suggesting that couples should undergo thorough checks and counseling before embarking on fertility treatments. This recommendation underscores the need for comprehensive support systems for individuals considering assisted reproduction, particularly as they navigate the complexities of age-related fertility challenges.

In conclusion, while the use of donor eggs can provide a valuable option for older women seeking to conceive, the findings of this study highlight the importance of understanding the biological limitations associated with age. As reproductive technologies continue to evolve, it is crucial for women to be informed about the potential risks and challenges they may face, allowing them to make educated decisions about their reproductive health and family planning options.