**EBC News Interview**
Becoming Reproductive Center, which continues to lead advancements in reproductive medicine, stated today (25th) 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 7-8 years compared with 40 years ago. In addition, the number of women aged 15-39 of reproductive age is expected to decline between 2015 and 2025, while the number of women aged 40-49 will increase by nearly 8%, clearly indicating that advanced maternal age will become the new normal. In view of this, egg quality and ovarian potential are key factors in achieving pregnancy. Becoming Reproductive Center approaches assisted reproduction through three strategies—egg freezing, egg accumulation, and donor eggs—to help women of reproductive age better understand fertility treatment. At the same time, the center advocates three major preconception care strategies: “Nurture Eggs and Support the Endometrium, Support Pregnancy and Protect Gestation, and Care for Health and Emotional Well-being.” The goal is to help more people achieve successful pregnancies. In addition, nearly 70% of egg retrieval cycles at Becoming Reproductive Center in 2020 involved women over the age of 38, yet the center still maintained a pregnancy rate of 55.5%, higher than the national average—an impressive achievement.
Negative Population Growth, Rising Female Workforce Participation, and Delayed Marriage and Childbearing: Facing the New Normal of Advanced Maternal Age
In 2020, the global COVID-19 pandemic brought significant changes to people's work and daily lives.
Although Taiwan's outbreak was relatively mild compared with many other countries, it faced a difficult demographic challenge in which deaths outnumbered births. According to the latest statistics from the Ministry of the Interior, there were 165,249 births and 173,156 deaths in 2020, marking Taiwan's first year of negative population growth. The National Development Council has even estimated that by 2070 Taiwan's total population may fall to 61-73% of its 2020 level, or approximately 14.49-17.16 million people. In addition, changes in social, economic, and educational structures, together with the rise of women in the workforce, mean that marriage and starting a family are no longer the sole priorities in life. Ministry of the Interior statistics show that the average age at marriage in 2019 was 34.7 for men and 32.1 for women, nearly 7-8 years older than 40 years earlier (1979). The National Development Council also estimates that between 2015 and 2025, the number of women aged 15-39 of reproductive age will decline by more than 20%, while the number aged 40-49 will increase by nearly 8%. Declining birth numbers and total population, delayed marriage, and an increase in women aged 40-49 of reproductive age all indicate that if Taiwan hopes to raise its birth rate, advanced maternal age will become a new normal.
For Advanced Maternal Age, Egg Potential Is Key: Egg Freezing, Egg Accumulation, and Donor Eggs to Support Your Fertility Journey
When facing advanced maternal age, one of the first and most anxiety-provoking concerns is impaired or declining ovarian function. For pregnancy to occur, egg quality influences whether fertilization and implantation will succeed. Fortunately, reproductive medicine continues to advance. Becoming Reproductive Center summarizes three approaches to help women of reproductive age understand assisted reproduction and seek professional consultation and support. Egg Freezing: For women who wish to postpone childbearing because of medical treatment or career development, or women showing early signs of premature ovarian insufficiency, egg freezing is generally recommended between ages 30-38 and preferably before age 40, so that healthier eggs may be preserved to improve future reproductive potential. Ideally, women under 35 should freeze around 15 eggs, those aged 35-40 around 20 eggs, and women over 40 may require more. In general, eggs should be cryopreserved within two hours after retrieval. Using the latest ultra-rapid vitrification technology(Vitrification), post-thaw survival rates may exceed 90%.
Egg Accumulation:
This approach is mainly intended for women aged 38-48 or those with AMH(Anti-Müllerian Hormone抗穆勒氏管賀爾蒙) below 1.2. A low AMH level indicates reduced ovarian reserve,
meaning fewer follicles and reduced egg quality. Generally speaking, the number of eggs retrieved may be approximately three times the AMH value. For example, with AMH=0.7, around 2 eggs may be expected; with AMH=3, around 9 eggs may be expected. Patients over 40, those who have previously retrieved no more than 3 eggs in IVF cycles, those with fewer than 5-7 antral follicles(AFC), or those with AMH values at or below 0.5-1.1 are generally classified as poor responders(Poor responder). In these cases, high-dose follicle-stimulating hormone(FSH) injections may be used, or adjunctive treatment with dehydroepiandrosterone(DHEA),
with the aim of increasing the number of antral follicles(Antral follicle), encouraging multiple follicles to develop during ovarian stimulation, obtaining more eggs for fertilization, selecting higher-quality embryos, and improving the chance of successful pregnancy.
Donor Eggs:
For women under 40 diagnosed with premature ovarian insufficiency or menopause, women over 40 experiencing accelerated ovarian decline, women with repeated failed egg retrieval and embryo transfer attempts, or women who have lost ovulatory function because of illness, discussing donor-egg IVF with a partner may be an option for fulfilling the dream of parenthood. If the wife is of advanced maternal age, has repeatedly failed IVF treatment, or has a history of recurrent miscarriage, preimplantation genetic testing(PGT-A) and endometrial receptivity analysis(ERA) may also be considered to help transfer a chromosomally suitable embryo at the optimal time and improve the chances of a healthy IVF pregnancy.
The Path to Parenthood Does Not Have to Be Endless—Clinical Experience Shows That Good Preparation Supports Better Pregnancy Outcomes
For patients who have difficulty conceiving, IVF may be one possible solution, but the preconception period before IVF is a critical part of the fertility journey that should not be overlooked. Dr. Li Hui-Po, Director of Becoming Reproductive Center, stated that in general, preparing for pregnancy for at least three months is recommended in order to support the birth of a healthy baby. Especially for patients experiencing infertility, the support and full participation of both the patient and family throughout preconception preparation and IVF treatment can help increase the chance of successful conception.
Becoming Reproductive Center also recommends initiating three comprehensive care strategies—“Nurture Eggs and Support the Endometrium, Support Pregnancy and Protect Gestation, and Care for Health and Emotional Well-being”—to address both physical and emotional health and move toward the goal of welcoming a healthy baby.
Nurture Eggs and Support the Endometrium:
A healthy, well-developed follicle is ideally around 18-23mm. To support the development of high-quality eggs, dietary recommendations include high-protein foods, nuts, soy products, folic acid+B-complex vitamins, inositol, vitamin D3, and other nutritional supplements to support ovarian health and slow age-related decline. Before embryo transfer, endometrial receptivity should also be assessed. Research data indicate that pregnancy rates are generally better when the endometrial thickness is greater than 7mm at ovulation. If the endometrium is too thin, professional medical treatment may be required to improve the likelihood of successful embryo implantation.
Support Pregnancy and Protect Gestation:
During pregnancy, appropriate nutrition is essential. Iron, folic acid, calcium, vitamin D, iodine, dietary fiber, and other nutrients should be consumed in appropriate amounts. Fresh and natural foods should be prioritized, while raw or cold foods, greasy foods, spicy and irritating foods, and alcohol should be avoided. If morning sickness affects appetite, smaller and more frequent meals may help. Maintaining a clean environment, developing regular exercise habits, and creating opportunities for stress relief can also reduce pregnancy-related discomfort, support a more安心 pregnancy, and strengthen the parent-child bond.
Care for Health and Emotional Well-being:
When preparing for pregnancy, people often focus on physical care such as maintaining a regular routine and staying healthy, while overlooking the mental health of women trying to conceive. The fertility journey can be long, yet it may also feel like a race against time. It is important to approach each stage positively and reduce factors that cause exhaustion or negative thinking whenever possible. Because the journey can be physically and emotionally draining, developing a hobby may help relieve fertility-related stress and reduce feelings of self-doubt and disappointment. It is also important to find a professional reproductive medicine team with whom you can communicate well, receive counseling, and share your experience. In addition,
if work is excessively demanding or stressful, couples are encouraged to discuss whether changes are needed to maintain a healthy balance among work, family, and daily life.
A partner's empathy and support play an extremely important role. Without such support, whether during pregnancy or when facing postpartum depression, the situation may become a difficult burden and challenge for the mother, baby, and entire family.
2020 Results Bring Good News: Becoming Reproductive Center Achieves a 55.5% Embryo Transfer Pregnancy Rate, Higher Than the National Average
In addition to accompanying patients through their fertility journeys with its three comprehensive preconception care strategies, Becoming Reproductive Center has actively promoted Single Embryo Transfer(Single Embryo Transfer, SET) since opening in April 2020. In early 2021, the center also welcomed the first birth resulting from treatment at the clinic. Dr. Li Hui-Po, Director of Becoming Reproductive Center, happily shared: “Ms. A had a uterine tumor accompanied by menstrual pain and anemia and had experienced miscarriages following two previous IVF treatments. She was later referred to me for surgical removal of the uterine tumor and preconception care. At age 44 last year, she received a frozen embryo transfer at Becoming Reproductive Center. Because of her age and previous surgery, we were concerned about risks such as gestational hypertension, diabetes, premature birth, uterine rupture, and fetal growth restriction. With continuous care and close monitoring from our team, she fortunately gave birth safely to a healthy and energetic baby at the beginning of this month. Amid the atmosphere of an ongoing pandemic, this was truly uplifting news and a great encouragement to our team.” Dr. Li further stated that the newly released 2020 assisted reproduction report from Becoming Reproductive Center showed that nearly 70% of egg retrieval patients were over the age of 38, yet the embryo transfer pregnancy rate reached an impressive 55.5%, outperforming the national embryo transfer pregnancy rate of 47.4% reported by the Health Promotion Administration for 2018. This demonstrates Becoming Reproductive Center's strong capability in meeting the challenges of advanced maternal age as the new normal.
We thank EBC News for recognizing Becoming Reproductive Center.
The team at Becoming Reproductive Center will continue working hard for every couple pursuing their dream of having a child.
Article link: https://news.ebc.net.tw/news/living/247048