The Podcast by KevinMD Uterine aging plays a critical hidden role in IVF outcomes
Feb 22, 2026
Oluyemisi Famuyiwa, a fertility specialist and clinician-scientist studying uterine aging. She spotlights how the aging uterus can undermine IVF success even with chromosomally normal embryos. Short segments cover endometrial thinning, senescent cells and epigenetic drift, declining progesterone responsiveness, limits of thickness measurements, and promising research on uterine clocks and senolytic therapies.
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Uterine Age Affects IVF Success
- The uterus ages independently from the egg and can reduce IVF success even with young donor eggs.
- Studies show embryos from younger donors implant less successfully in older recipients, revealing a uterine-age effect on pregnancy rates.
Structural Changes Undermine Implantation
- Aging makes the endometrium thinner and less able to decidualize, reducing implantation resilience.
- Structural blood vessel changes and altered stromal cell behavior transform a receptive lining into an unfavorable implantation environment.
Epigenetic Drift And Senescent Cells
- Two aging mechanisms matter: epigenetic drift (software) and accumulation of senescent 'zombie' cells (hardware impact).
- Epigenetic drift corrupts gene regulation each cycle while senescent stromal cells produce inflammatory signals that harm neighbors.