Post Menopausal Women Became Mother at the Age of 52 years

The efforts to utilize science have given benchmark in the cases of unfortunate childless, infertile and post menopause women becoming mothers.

Pregnancy at 52 Years : (Post Menopausal Women)

Patient age 52 years resident of Hyderabad, India with primary infertility had heard about the treatment for conception with oocyte donation after menopause. Patient came to ask regarding the possibilities of pregnancy by oocyte donation from her young relative and sperm from husband who is age about 63 years. On general examination she is found to be mild hypertensive with a weight of about 60 kgs. She was menopausal from past 4 years and it was confirmed by blood investigations and Ultrasonography. Both husband and wife gave consent for the procedure. Patient was kept on ormone, estrogen to which she responded by producing endometrium lining. After 25 days of estrogen therapy that is on 5th October 2001, she had embryo transfer, where three embryos were transferred and she was kept on hormonal support the oocyte were donated by one her relative who already have children and aged about 25 years. Pregnancy test was positive on 24 october 2001. On ultrasonography (1-November 2001) she was detected to have viable intrauterine pregnancy and then on she routinely under observation. The well being of pregnancy was monitored by ultrasonography. She carried the pregnancy till term. She under went caesarian section on 13 June 2002 and delivered a male baby of 2.8 Kgs. They was discharged from the hospital after 72 hrs.

Patient Age Complication Gest.Age at Delivery Weight of Baby Stay in ICU Mrs. X 52 Pregnancy accelerated hypertension Term gestation 2.8 Kgs Nil

Some Facts about the Ovum Donation

Sources of oocyte donation

Voluteers Relatives Professional donors Egg Sharing (Patients Needing IVF/ICSI who cannot afford entire ART Cycle)

Donor Selection

Age less than 33 years No Genetics / Infectious history Counselling and informed consent

Preparation Endometrium in Recipient

Estradiol valerate 6mg / day Micronised progesterone 600mg/day

Day 14 serum beta hCG

Ist Trimester Support

6-8mg of Estradiol valerate orally per day - 10-12 wks 600 mg Micronised progesterone - 14-16 wks Folic acid 5mg / day

IInd Trimester monitoring

Weight & BP Recording USG Monthly Hemoglobin, RBS, CUE Iron and Calcium Supplementation

IIIrd Trimester monitoring

Doppler at 28 wks NST weakly after 30 - 32 wks BPP Monthly Prophylactic dexamethasone IM weakly

Complications with Pregnancies in menopausal women

7% gestational Diabetes mellitus 20 - 30% Hypertension Placenta Previa IUGR Increased LSCS Rate