AART has many internal policies which may be shared with patients throughout their treatment as required. Below is information on two of our policies that many patients ask about before booking an initial assessment.

Age Limit

The Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Guideline (2017) reports a significant drop in IVF live birth rates in women greater than or equal to 43 years of age and no live births for women greater than or equal to 45 years of age.

The American Society of Reproductive Medicine (ASRM) defines futile treatment as having less than a 1% chance of success. According to ASRM, patients undergoing IVF at age 44 or greater have a 0.6% chance of a live birth (ASRM 2014. Female age-related fertility decline Committee Opinion).

As a result of this information, a literature review, and input from our Ethics Committee, AART’s age limit for IVF is under 44 years of age. This means the patient needs to complete their IVF stimulation cycle and retrieval before their 44th birthday.

If a patient who undergoes IVF at or near the age limit has any resulting frozen embryos and wishes to use them when they are 44 years of age or over, AART can perform a frozen embryo transfer (FET) up to age 51 (the natural age of menopause), which is the internationally accepted age limit for gestational carriers.

BMI

There is no BMI limit to be seen for an initial assessment. For surgical and conscious sedation safety reasons, a patient has a BMI greater than or equal to 40 they will not be offered IVF at AART. AART may perform Intrauterine Insemination (IUI) and Donor Insemination (DI) for patients with a BMI greater than or equal to 40.  AART can also perform a frozen embryo transfer (FET) of one embryo for patients who have a BMI greater than or equal to 40. The risks that morbid obesity present to the patient and fetus will be discussed with the patient prior to the procedure. 

AART is a private clinic and does not operate in a hospital setting. The Department of Anesthesia, in many institutions throughout the world, recommend out of hospital anesthesia not be given in patients with morbid obesity. Numerous governing bodies in the IVF community recommend surgical procedures, such as IVF retrievals, not be performed outside of a hospital setting on patients with morbid obesity for surgical and conscious sedation safety reasons.

Additionally, patients with morbid obesity have an increased risk of being poor responders to stimulation and can be difficult to scan (ultrasound). They also have an increased likelihood of serious pregnancy complications for the mother and child.

If a patient has a BMI greater than or equal to 40 they will not be offered IVF at AART. The patient will be counselled by the physician on our policy and if they wish to reduce their BMI we can provide a referral to a Dietician or physician who specializes in this area. If they are able to reduce their BMI to below 40 they can proceed with IVF.

If the patient is not interested in reducing their BMI to below 40 and wishes to undergo IVF, AART can provide a referral to another clinic that is within a hospital setting.