International Reproductive Experts Interpret Successful Strategies and Assisted Reproductive Options in Georgia

In contemporary society, with evolving career trajectories and life planning, an increasing number of women choose to start families at age 35 or later. Medically, expectant mothers whose estimated delivery date falls at or beyond 35 years of age are classified as ‘advanced maternal age’. While advancing age presents distinct challenges to conception, this by no means signifies the end of one’s reproductive aspirations. Through systematic, scientifically grounded preconception planning and thorough understanding of modern assisted reproductive options—including IVF in Georgia—older women can substantially enhance their chances of achieving a successful pregnancy and delivering a healthy baby.

Step One: Comprehensive Preconception Assessment – Laying the Scientific Foundation

At the outset of preconception planning, it is crucial for both partners to undergo a thorough fertility evaluation, extending far beyond routine medical examinations. For older couples, the core focus lies in assessing their ‘fertility potential’.

Key assessment items for women include:

Ovarian Reserve Function: This forms the cornerstone of fertility assessment. Key indicators include:

• Anti-Müllerian Hormone (AMH): Directly reflects the number of remaining eggs in the ovaries. Typically, an AMH level below 1.1 ng/ml indicates diminished ovarian reserve.
• Antral Follicle Count (AFC): Assessed via transvaginal ultrasound on days 2-3 of the menstrual cycle, counting small follicles in both ovaries. An AFC below 5-7 may suggest fewer viable eggs.
• Sex Hormone Panel: Also assessed during the menstrual cycle’s early phase. Persistently elevated follicle-stimulating hormone (FSH) levels above 10 IU/L may indicate declining ovarian function.
• Uterine and Fallopian Tube Health: Gynaecological ultrasound evaluates uterine morphology (e.g., presence of fibroids or polyps), endometrial condition, and assesses tubal patency.
• General Health Screening: Assesses thyroid function, blood glucose, lipid profile, and vitamin D levels. For instance, thyroid dysfunction (with TSH ideally maintained between 0.1–2.5 mIU/L) and vitamin D deficiency directly impact conception and embryonic development.

Male examinations are equally crucial. Beyond routine semen analysis, older men (typically aged ≥40) are advised to undergo sperm DNA fragmentation testing. Elevated levels (>15%) increase difficulties in natural conception and miscarriage risks.

Dr Emma Richardson of London Fertility Centre emphasises: ‘For older couples, a comprehensive fertility assessment serves as a roadmap, indicating our starting point and the optimal route to our destination. This evaluation is an indispensable first step before considering any treatment, including international IVF surrogacy programmes in Georgia.’

Step Two: Targeted Nutritional and Lifestyle Interventions — Optimising the Internal Environment

Following medical assessment, tailored physical conditioning is pivotal for enhancing egg and sperm quality.

1. Nutritional Strategy:

Boost Key Nutrients: Older women typically require higher folate intake than younger women; daily supplementation of 0.8mg of active folate is recommended. Concurrently, prioritise coenzyme Q10 (100-300mg daily), vitamin D (800-1000 IU daily), and omega-3 fatty acids. These nutrients provide antioxidant benefits, enhance mitochondrial function, and support endocrine balance.

Optimising Dietary Structure:

Increase intake of high-quality protein (e.g., fish, lean meats, eggs, soy products) to provide building blocks for follicular development. Maintain dietary diversity with ample dark-coloured vegetables and berry fruits.

Strictly Avoiding Contraindications:

Both partners should cease smoking and alcohol consumption entirely 3-6 months prior, while limiting caffeine intake (less than 200mg daily).

2. Exercise and weight management:

Moderate physical activity improves pelvic blood circulation and regulates hormones. Aim for 3–5 sessions per week of moderate-intensity aerobic exercise (e.g., brisk walking, swimming, yoga) lasting approximately 30 minutes each. Maintaining a Body Mass Index (BMI) within the ideal range of 18.5–24.9 is crucial, as both overweight and underweight conditions can disrupt normal ovulation.

3. Environment and Routine:

Avoid prolonged exposure to high temperatures, radiation, and harmful chemical substances. Ensuring 7-8 hours of quality sleep nightly and establishing a regular routine are vital for stabilising the function of the hypothalamic-pituitary-ovarian axis.

Step Three: Seizing the Moment and Proactively Seeking Medical Assistance

Advanced maternal age necessitates a more proactive approach to timing conception. It is advisable to precisely pinpoint the ovulation window through ovulation predictor kits or ultrasound monitoring. Should conception remain unsuccessful after 3-6 months of scientifically guided preparation, timely consultation with a fertility specialist is recommended to discuss further intervention options.

Assisted reproductive technologies offer robust support for women of advanced maternal age. For instance, in vitro fertilisation (IVF) can address issues such as diminished ovarian reserve or blocked fallopian tubes. For women over 40, where the risk of embryonic chromosomal abnormalities significantly increases (exceeding 50% in this age group), preimplantation genetic testing (PGT) can screen embryos for chromosomal abnormalities. This reduces miscarriage rates from approximately 40% to around 15%, thereby enhancing live birth rates.

Step Four: Choosing with an International Perspective – Exploring Assisted Reproduction Pathways in Georgia

For older couples facing complex fertility challenges, such as requiring third-party assisted reproduction (e.g., egg donation, surrogacy) to realise their family aspirations, turning to international destinations with mature legal frameworks and regulated healthcare systems presents a viable option. Among these, Georgia’s IVF and surrogacy services have become a considered choice for many international families due to its clear legal safeguards, relatively reasonable costs, and high medical standards.

When considering Georgian IVF surrogacy or any international assisted reproduction programme, it is imperative to engage an international consultancy agency that collaborates with reputable, accredited fertility centres. Such professional institutions not only provide preliminary medical consultations and procedural arrangements but also ensure full compliance with international standards and local legislation throughout the entire process—from medical procedures to legal documentation preparation—safeguarding prospective parents’ legitimate rights and interests.

Summary: Scientific Planning, Embracing Possibilities

Advanced maternal age fertility planning is a journey requiring patience, science and confidence. Its core pathway can be summarised as follows: commencing with a comprehensive fertility assessment, optimising one’s condition through precise nutritional and lifestyle interventions, actively utilising modern reproductive medicine technologies to seize the right moment, and maintaining an open international perspective to realise family aspirations.

As Dr James Wilson of the University of California Reproductive Health Centre observes: ‘Age is a factor affecting fertility, but it need not be an obstacle. Today’s reproductive medicine offers unprecedented tools and options. The key lies in taking proactive steps, devising personalised strategies, and persevering with conviction.’ Whatever the path, the ultimate reward—a healthy new life—will make every effort worthwhile.