IVF over 50 in North Cyprus – What You Must Know

Female infertility is the most common reason why women or couples seek assistance from IVF clinics abroad for egg donation. Utilising donor eggs can effectively overcome infertility related with advanced maternal age and has supported numerous people over the years. Patients undergoing these treatments are often those who postponed childbearing to pursue other life goals. Unfortunately, fertility naturally declines with age, and many healthy women face challenges due to aging, as current medical remedies or options do not reverse this decline.

What Are My Chances of Conceiving After 30?

Dr. Berk Angün, the Medical Director of Dunya IVF, shares his insights and expertise on the topic of IVF Over 50 in North Cyprus. Discover his professional perspective on the possibilities and considerations for pursuing IVF treatment beyond the age of 50.

Dr Berk Angün, the Medical Director of Dunya IVF

“Naturally, female fertility begins to decrease around the age of 30. At the age of early 20s, a woman’s chance of conceiving is approximately 25% per month. By age 35, this chance is halved. The downward slope continues until by age 45 where the natural fertility rate per month is approximately 1%. Therefore, in general, women over 45 are advised against undergoing IVF with their own eggs. Instead, we, reproductive specialists, recommend using donor eggs, as older eggs are more likely to have chromosomal abnormalities that can result in miscarriage or developmental or growth problems. Women over the age of 50 are generally not considered candidates for IVF using their own eggs.”, explains Dr. Berk Angün.

Even women in their 50s have achieved high success rates with donor eggs despite reaching menopause, indicating that the uterus remains receptive to pregnancy longer than the ovaries. However, concerns about declining endometrial receptivity with age persist. A retrospective study of nearly 28,000 fresh donor cycles showed significantly lower implantation, clinical pregnancy, and live birth rates in recipients over 45.

Pregnancy After 40: Risks and Complications

As such, women of any age who have access to viable eggs or embryos from a donor and a receptive uterus can pursue motherhood through fertility treatments. However, understanding the risks of pregnancy and perinatal complications after age 40 is crucial.

Studies evaluating obstetric outcomes following oocyte donation have generally shown favourable results, though these pregnancies may also be associated with higher rates of obstetric complications such as pregnancy-induced hypertension, increased likelihood of Caesarean delivery, heart diseases, obstetric haemorrhage, and diabetes. With careful screening of such patients, these complications are manageable, and healthy children can reasonably be expected.

IVF pregnancies over 40 and 50 may also be associated with higher rates of obstetric complications such as pregnancy-induced hypertension, increased likelihood of Caesarean delivery or obstetric haemorrhage.

Due to these potential risks, the Ministry of Health in Northern Cyprus requires additional tests and consultations (these tests might change due to any updates in the legislations and the patient will be informed about them after she will contact our clinic) for donor recipient candidates over 50 to ensure their general well-being before starting their fertility treatments.

These tests can be conducted in the patient’s home country and submitted to our clinic via email, or patients can visit Cyprus for arranged appointments with local doctors and laboratories.

Tests, Consultations, and Documents Required for Donor Recipients Over 50

Additional tests/consultations might be necessary depending on the patient’s medical/surgical history.

Tests, Consultations, and Documents Required for Donor Recipients Over 55

After age 55, additional tests and documents (these tests might change due to any updates in the legislations and the patient will be informed about them after she will contact our clinic) mandated by the Ministry of Health in Northern Cyprus must be completed locally before treatment can proceed.

Dunya IVF Clinic coordinators guide their patients through this process, arranging all necessary appointments and ensuring compliance with current regulations.

These tests/consultations/documents are:

Additional tests/consultations might be necessary depending on the patient’s medical/surgical history.

Once all tests and consultations are completed and approved by the Ministry of Health in Northern Cyprus – times are determined by Ministry of Health Committee- (approximately 3-6 weeks is expected range), treatment preparations for both the donor and patient can begin.

Egg Donors in North Cyprus

Egg donation regulations vary by country. In North Cyprus, regulations mandate anonymity and confidentiality, ensuring that donors remain unaware of whether their eggs result in a successful pregnancy, and recipients and their children do not receive any identifying information about the donor beyond physical characteristics. In other words, identities of both the donor and the recipient are kept secret.

Egg donors in North Cyprus remain anonymous to the donor egg recipients.

In Cyprus, donors play a crucial role in helping patients achieve their dreams of parenthood. At Dunya IVF Clinic, the staff prioritises their health care and ensure that both the patients and donors receive comprehensive support throughout each treatment cycle.

Donor candidates at Dunya IVF clinic must be between 21 and 30 years old and undergo thorough medical assessment, physical examination, and psychological evaluations. In addition, their screening includes blood group and Rh factor testing, confirmation of absence of transmissible diseases (Hepatitis, Syphilis, HIV), and genetic screening.

“Only candidates meeting all criteria and fully prepared for the responsibilities of egg donation are accepted, a process currently allowing just 35% of applicants to donate,” says Dr. Berk Angün, the Medical Director of Dunya IVF.

The Process of IVF in North Cyprus

1. No waiting time. While there is no waiting list at our clinic, we advise our patients to notify us at least one month before their treatment date to synchronise menstrual cycles of the donor and the recipient for fresh egg donation cycles, if necessary.
2. Treatment protocol. The protocols are selected based on medical history and availability, typically starting within the first 3-5 days of the menstrual cycle after an ultrasound scan confirming the absence of an ovarian, endometrial, or a uterine abnormality.
3. Edometrium assessment. For fresh egg donation cycles, after 12-16 days of monitoring, we evaluate the endometrial pattern. Once it is confirmed that endometrium is ready, semen sample is obtained and the ICSI procedure is performed on the donor’s egg retrieval day.
4. Hormones. Progesterone is also administered to the patient the same day to prepare the endometrium for embryo transfer. That day (ICSI day) is counted as day 0 of the embryo development, so the next day is counted as day 1.
5. Embryo development stage. Up until the transfer day which is performed on day 5 of the embryo development, patients receive regular updates on embryo development by the embryology team via phone calls. On day 4 the patient is informed about what time to come to the clinic on the following day for the embryo transfer procedure.
6. Embryo transfer. On day 5, we invite our patients to our clinic and they have a face-to-face meeting with the embryology team and then we perform the blastocyst transfer. The embryo transfer procedure is performed in a lithotomy position and is typically does not require anaesthesia due to its generally painless nature. The only prerequisites are that the patient arrives with a full bladder and refrains from using any perfume or any deodorants.

Before and After Embryo Transfer

In general, we recommend that patients adopt a healthy lifestyle before and after embryo transfer, including a balanced and nutritious diet, sufficient hydration, minimal processed foods and added sugars, cessation of smoking and alcohol, regular exercise, and a positive mindset.

Single embryo transfer is also advised to reduce risks of multiple pregnancies. Patients should undergo close obstetric monitoring post-pregnancy due to aforementioned risks.

Medical Assessment Before Embryo Transfer

Patients who have medical conditions that make pregnancy unsafe, such as hormone-sensitive cancers (e.g., certain types of breast cancers), severe heart or neurological disorders, or uncontrolled diabetes or hypertension, must undergo specialist evaluation, receive appropriate treatment to manage their conditions, and obtain official approval before starting any treatment.

Besides, the presence of a hydrosalpinx (fluid-filled tubes in the female reproductive system) is known to adversely affect implantation and pregnancy rates. Therefore, it is recommended to undergo surgical treatment with laparoscopic salpingectomy to remove the affected tube.

Furthermore, prior to initiating any fertility treatment, recipients should ensure their uterine cavity is normal, free from adhesions, space-occupying lesions, and any abnormalities that could distort the endometrial cavity in order to maximize success rates. This assessment is best conducted using methods such as transvaginal ultrasound, pre-cycle sonohysterogram, hysterosalpingography, or diagnostic hysteroscopy.

IVF Success Rates in North Cyprus

In consultations, we often address the misconception that statistics regarding success rates in egg donation cycles apply universally rather than individually. While success rates of 65-70% may seem high, it also means that 30-35% of patients may not achieve pregnancy despite optimal conditions.

Educating patients on these statistics helps manage expectations – this prevents the clinician from discouraging the patient or providing false hope – and ensures realistic evaluation.

Should I Genetically Test my Embryos?

Recently, pre-implantation genetic testing for aneuploidies (PGT-A) is increasingly used by the clinics to utilise pre-implantation genetic screening to select euploid – in other words; better embryos for transfer, potentially reducing time to pregnancy but not necessarily improving recipients’ live birth rates or lowering miscarriage rates.

There is ongoing debate regarding the utility of PGT-A in this population, especially given that it comes at increased cost to the patient. So, patients should be getting a proper consultation about the advantages and disadvantages of such genetic screening procedures.

If you wish to have your IVF success changes estimated, get in touch with Dunya IVF team. There’s no obligation.

References:

1. Storgaard M, Loft A, Bergh C, Wennerholm UB, Soderstrom-Anttila V, Romundstad LB, et al. Obstetric and neonatal complications in pregnancies conceived after oocyte donation: A systematic review and meta-analysis. BJOG. 2017;124(4):561–72.
2. Soares SR, Troncoso C, Bosch E, Serra V, Simon C, Remohi J, et al. Age and uterine receptiveness: Predicting the outcome of oocyte donation cycles. J Clin Endocrinol Metab. 2005;90(7): 4399–404.
3. Practice Committee of the American Society for Reproductive Medicine and the Practice Committee for the Society for Assisted Reproductive Technologies. Guidance on the limits to the number of embryos to transfer: A committee opinion. Fertil Steril. 2021;116(3):651–4.
4. Doyle N, Gainty M, Eubanks A, Doyle J, Hayes H, Tucker M, et al. Donor oocyte recipients do not benefit from preimplantation genetic testing for aneuploidy to improve pregnancy outcomes. Hum Reprod. 2020;35(11):2548–55.
5. Ubaldi FM, Cimadomo D, Vaiarelli A, Fabozzi G, Venturella R, Maggiulli R, et al. Advanced maternal age in IVF: Still a challenge? The present and the future of its treatment. Front Endocrinol (Lausanne). 2019;10:94.
6. Yeh JS, Steward RG, Dude AM, Shah AA, Goldfarb JM, Muasher SJ. Pregnancy outcomes decline in recipients over age 44: An Analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the society for assisted reproductive technology. Fertil Steril. 2014;101(5):1331–6.
7. Rizzello F, Coccia ME, Fatini C, Badolato L, Fantappie G, Merrino V, et al. Comorbidities, risk factors and maternal/perinatal outcomes in oocyte donation pregnancies. Reprod Biomed Online. 2020;41(2):309–15.
8. Jeve YB, Potdar N, Opoku A, Khare M. Donor oocyte conception and pregnancy complications: A systematic review and meta-analysis. BJOG. 2016;123(9):1471–80.

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