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Advanced-Age Childbearing Becomes the Norm: A New Fertility Preparation Strategy Through “Egg Freezing, Egg Accumulation, and Egg Donation” to Fulfill the Dream of Having a Child — EBC News Interview
EBC News Interview, January 25, 2021
Yun-I Reproductive Center, which continues to lead in assisted reproductive medical technology, stated today, January 25, that Taiwan is facing the challenge of negative population growth. Late marriage has become a trend, with the average age of marriage increasing by nearly 7 to 8 years compared with 40 years ago.
In addition, from 2015 to 2025, the number of women of reproductive age between 15 and 39 is expected to decline, while the number of women aged 40 to 49 is expected to increase by nearly 8%. This clearly shows that advanced-age childbearing will become a new norm.
In view of this, egg quality and ovarian reserve have become the key to successful pregnancy. Yun-I approaches fertility support through three strategies: egg freezing, egg accumulation, and egg donation. These strategies help women of reproductive age better understand assisted reproduction.
At the same time, Yun-I advocates three major fertility preparation strategies: nourishing eggs and protecting the endometrium, supporting pregnancy and fetal development, and caring for both body and mind.
In 2020, nearly 70% of egg retrieval cycles at Yun-I involved women over the age of 38. Despite this, Yun-I maintained a pregnancy rate of 55.5%, which is higher than the national average. This is a remarkable achievement.
Negative population growth, rising female workforce participation, late marriage, and delayed childbearing: facing the new norm of advanced-age pregnancy
In 2020, COVID-19 changed the way people around the world worked and lived. Although Taiwan’s pandemic situation was relatively mild compared with many other countries, Taiwan faced a serious demographic challenge.
According to the latest statistics from the Ministry of the Interior, there were 165,249 births and 173,156 deaths in 2020. Taiwan experienced negative population growth for the first time.
The National Development Council further estimates that by 2070, Taiwan’s total population may decline to 61% to 73% of the 2020 level, which would be approximately 14.49 million to 17.16 million people.
Due to changes in society, the economy, and education, women have become increasingly active in the workforce. Marriage and family are no longer the only life focus. Statistics from the Ministry of the Interior show that the average age of marriage in 2019 was 34.7 for men and 32.1 for women, an increase of nearly 7 to 8 years compared with 1979.
The National Development Council also estimates that between 2015 and 2025, the number of women of reproductive age between 15 and 39 will decrease by more than 20%, while the number of women aged 40 to 49 will increase by nearly 8%.
Therefore, declining birth numbers, a shrinking total population, delayed marriage, and an increase in women aged 40 to 49 all indicate that advanced-age childbearing will become a new norm if Taiwan hopes to improve its birth rate.
The key to advanced-age pregnancy is egg quality: egg freezing, egg accumulation, and egg donation
When facing advanced-age childbearing, the first and most anxiety-provoking issue is ovarian dysfunction or ovarian decline.
For successful pregnancy, egg quality affects whether fertilization or implantation can succeed. However, reproductive medicine continues to advance. Yun-I summarizes three approaches to help women of reproductive age better understand assisted reproduction and seek professional consultation and support.
Egg Freezing
Egg freezing is recommended for women who wish to delay childbearing due to medical treatment, career planning, or early signs of premature ovarian insufficiency.
The recommended age for egg freezing is 30 to 38, preferably before the age of 40, in order to retrieve healthier eggs and improve the chance of future fertility success.
For women under 35, freezing around 15 eggs is recommended. For women aged 35 to 40, around 20 eggs may be needed. Women over 40 may require even more.
Generally, eggs should be frozen within 2 hours after retrieval. With the latest vitrification ultra-rapid freezing technology, the survival rate of thawed eggs can exceed 90%.
Egg Accumulation
Egg accumulation mainly applies to women aged 38 to 48, or women with AMH below 1.2. A low AMH level indicates declining ovarian reserve, meaning fewer follicles and lower egg quality.
In general, the expected number of retrieved eggs is approximately three times the AMH value. For example, if AMH equals 0.7, about 2 eggs may be retrieved. If AMH equals 3, about 9 eggs may be retrieved.
Patients over 40, those who retrieved no more than 3 eggs in previous IVF cycles, those with fewer than 5 to 7 antral follicles, or those with AMH below or equal to 0.5 to 1.1 are considered poor responders.
In such cases, high-dose follicle-stimulating hormone FSH injections may be needed, or adjuvant treatment such as DHEA may be used. The goal is to increase the number of antral follicles, stimulate the formation of multiple follicles during ovulation induction, retrieve more eggs for fertilization, select better-quality embryos, and improve pregnancy success rates.
Egg Donation
For women under 40 diagnosed with premature ovarian insufficiency or early menopause, women over 40 with accelerated ovarian decline, women who have repeatedly failed egg retrievals or embryo transfers, and women who have lost ovulation function due to disease, egg donation may be considered after discussion with a partner.
For women of advanced maternal age, those who have repeatedly failed IVF, or those with a history of recurrent miscarriage, additional testing such as PGT-A and ERA may be recommended. These tests help identify chromosomally normal embryos and determine the best timing for precise implantation, thereby increasing the success rate of a healthy IVF pregnancy.
Clinical experience shows: preparing well before pregnancy leads to better outcomes
For patients facing fertility challenges, IVF may be one solution. However, the preparation period before IVF is also a critical stage that should not be overlooked.
Dr. Hui-Po Li, Director of Yun-I Reproductive Center, stated that in general, at least three months of preparation are needed to support the birth of a healthy baby. For patients with fertility difficulties, success is more likely when the patient and family members provide support and participate throughout the preparation and IVF process.
Yun-I also recommends three care strategies: nourishing eggs and protecting the endometrium, supporting pregnancy and fetal development, and caring for both body and mind. These strategies address the physical and emotional needs of patients as they move toward the goal of having a healthy baby.
Nourishing eggs and protecting the endometrium
An ideal healthy follicle is approximately 18 to 23mm in size. To support high-quality eggs, dietary recommendations include high-protein foods, nuts, soybeans, folic acid with vitamin B complex, inositol, vitamin D3, and other nutritional supplements to help slow ovarian aging.
Before embryo transfer, it is also necessary to evaluate whether the endometrium has good receptivity. Studies show that pregnancy rates are better when the endometrial thickness at ovulation is above 7mm. If the endometrium is too thin, professional medical treatment may be needed to improve the chance of successful embryo implantation.
Supporting pregnancy and fetal development
During pregnancy, proper nutrition is essential. Moderate supplementation of iron, folic acid, calcium, vitamin D, iodine, and dietary fiber can help support fetal development.
The diet should focus on fresh and natural foods. Raw, cold, greasy, spicy, irritating foods, and alcohol should be avoided. If morning sickness affects appetite, small frequent meals may help.
Maintaining a clean environment, developing a regular exercise routine, and creating stress-relieving situations can help reduce pregnancy discomfort, support fetal development, and strengthen the parent-child bond.
Caring for both body and mind
When trying to conceive, physical care such as maintaining a regular daily routine and good health is important. However, many people overlook the mental health of women preparing for pregnancy.
The fertility journey can be long, yet it often feels like a race against time. Patients need to face each stage with a positive mindset and reduce factors that lead to exhaustion or negative thinking.
This may be a physically and emotionally draining journey. It is recommended to cultivate a hobby to relieve fertility-related pressure and reduce feelings of self-blame or disappointment. It is also important to find a professional assisted reproduction team that supports communication, consultation, and sharing throughout the process.
If work is too busy or stressful, couples should discuss whether adjustments are needed in order to maintain balance among work, family, and life. The partner’s empathy and support play a critical role. Without that support, pregnancy or postpartum depression may become a heavy burden and challenge for the mother, baby, and entire family.
Yun-I reports strong 2020 results: embryo transfer pregnancy rate reaches 55.5%, higher than the national average
In addition to accompanying patients through the fertility journey with the three major preparation strategies, Yun-I has actively promoted single embryo transfer since its launch in April 2020. In early 2021, the center also welcomed its first birth.
Dr. Hui-Po Li shared: “Ms. A had uterine tumors, menstrual pain, and anemia. She had undergone two IVF treatments, both ending in miscarriage. She was later referred to me for uterine tumor surgery and fertility preparation. At the age of 44, she received a frozen embryo transfer at Yun-I. Because of her age and prior surgery, we were concerned about risks such as gestational hypertension, diabetes, preterm birth, uterine rupture, and fetal growth restriction. With constant care from our team, she fortunately delivered a healthy and energetic baby earlier this month. During a time filled with the tension of the pandemic, this was truly encouraging and inspiring for our team.”
Dr. Li further explained that according to Yun-I’s latest 2020 assisted reproduction report, nearly 70% of patients undergoing egg retrieval at Yun-I were over the age of 38. Even so, Yun-I achieved an embryo transfer pregnancy rate of 55.5%, outperforming the 2018 national embryo transfer pregnancy rate of 47.4% published by the Health Promotion Administration.
This demonstrates Yun-I’s strong capability to meet the challenges of advanced-age childbearing as a new norm.
Thank you to EBC News for recognizing Yun-I Reproductive Center. The Yun-I team will continue working hard for every couple hoping to have a child.
