Women over 40 lead surge in demand for IVF

Women over the age of 40 are flocking to fertility clinics in a final attempt to start a family before their biological clock stops ticking, latest figures show.

The fortysomethings are the fastest-growing group of patients seeking IVF, up from less than 1,000 in 1991 to more than 6,000 in 2006.

Demand for IVF has soared for all age groups in the past decade, with almost 40,000 cycles of treatment provided in 2006. Forty-plus women have led the surge, rising from 10 per cent of all cycles in 2000 to more than 15 per cent in 2006.

Experts said the trend was a consequence of the social pressures on women to delay starting a family while establishing their careers and growing awareness of the potential of fertility treatment. But they warned that many older women faced having their hopes dashed as success rates for IVF declined sharply with advancing years.

The figures also reveal rising demand from single and lesbian women. Cycles of treatment provided to single women increased from 600 in 1999 to more than 1,200 in 2006. The number of treatment cycles for lesbian couples rose from 300 to almost 1,000 in the same period.

Medical advances and improvements in technique have seen success rates for treatment increase dramatically. The overall live birth rate has risenfrom 14 per cent per cycle of treatment in 1991, to 21 per cent in 2006. The success rates are even higher for women under the age of 35 with more than one in four becoming pregnant at the first attempt. But the rates fall sharply after women pass the age of 35, declining to 12 per cent at age 40.

Moreover, the over-40s have not seen the improvement in live birth rates experienced by younger women. Success rates have improved only slightly over the past 15 years as doctors have run up against the barrier of female biological clock. After the age of 43, more than 95 per cent of patients treated return home childless.

Angela McNab, chief executive of the Human Fertilisation and Embryology Authority (HFEA), which published the figures on the occasion of the authority's annual conference in London yesterday, said the growth in demand from women over 40 was worrying. "Scandinavian countries are seeing the trend to delay motherhood even more markedly," she said. "It is a matter of concern. We may need to remind women about the biological clock and the difficulty of achieving pregnancy over 40."

She denied that clinics were pushing the treatment to older women, citing the practice of some doctors to refuse treatment to women in their forties. "I don't think the clinics are over-selling IVF [to older women]," she said. "I think there is greater awareness among the public about infertility and the range of treatments available."

NHS trusts refuse to fund treatment for women over the age of 40 on advice from the National Institute for Clinical Excellence (Nice) because of the low success rate, leaving women to pay for the treatment.

The average cost of a cycle of treatment ranges from £4,000 to £8,000. A woman having three or four cycles faces a bill of at least £12,000 and up to £32,000.

Sam Abdalla, director of the Lister fertility clinic, said society was imposing a "massive strain" on women by forcing them to choose between family and career. "It puts more of a burden on the women because it reduces their chances of conceiving and puts more strain on the treatment, especially in women over 45." He added that treatment in women over 40 was "less successful, with fewer pregnancies, a higher miscarriage rate and a lower live birth rate". But he stressed that the vast majority of women seeking treatment - 85 per cent - were under 40 with around half under 35.

For these women, the HFEA plans to publish figures showing the cumulative success rate for two or more cycles of treatment, to help those who fail to get pregnant at the first attempt decide whether it is worth continuing. Preliminary calculations show women under 35 increase their chances of having a baby from 26 per cent with one cycle of treatment to 55 per cent with three cycles. Nice recommends three cycles on the NHS but most NHS trusts provide only one cycle.

Ms McNab said: "The figures speak well for themselves. What that means for the primary care trusts is for them to consider."

The figures show a rise in the proportion of couples in whom male infertility is reported. Experts said this was likely to be due to better diagnosis of male problems rather than an increase in men with infertility.