TIME Aging

This Is When Women Using IVF Should Consider Donor Eggs

The latest study says success rates decline considerably after this age

In a report presented at the European Society of Human Reproduction and Embryology, researchers provided some much-needed information that they hope will help couples using IVF to make more informed decisions about how best to use the reproductive technology.

Infertility increases with age, and while there are many reasons why couples have a hard time conceiving, one important contribution is the quality of the woman’s eggs. Because women are born with all of the eggs they use throughout their lifetime, the older the eggs are, the more vulnerable they are to developing genetic and other abnormalities that make them weaker candidates for getting fertilized by sperm and developing into a healthy baby.

But at what age does this process truly decline? Most reproductive data shows that live birth rates start to decline when the woman reaches 35, so Dr. Marta Devesa from the department of obstetrics and gynecology at Women’s Health Dexeus in Barcelona, Spain and her colleagues decided to analyze birth rates by age and whether women used fresh or frozen embryos in their IVF cycle. They found that the cumulative live birth rate—which includes every transfer of an embryo from a single stimulation cycle (most women produce multiple eggs and many of these are fertilized to become embryos, one of which is usually transferred to the womb and the rest of which are frozen for future transfer)—dropped with age.

MORE: Exclusive: Meet the World’s First Baby Born With an Assist from Stem Cells

But they also learned that the live birth rate was really driven by the first transfer of the fresh embryo, and wasn’t significantly increased by transferring additional frozen embryos if the first transfer didn’t result in a pregnancy. In other words, the first, fresh embryo provides the best chance for pregnancy, particularly in women age 42 or older. “The benefit from the frozen embryos is very limited,” says Devesa.

The findings don’t suggest that freezing embryos isn’t worth the effort or the cost, however. For women ages 38-39, the extra benefit from transferring frozen embryos a live birth was 13%; for women ages 40-41, 9%, and for women 42-43, 2%. For women 42 years or older, the frozen embryos only added a 1% increased chance of a live birth. For them, their chances of pregnancy may be higher with a donor egg.

The number of embryos may also be an indicator of a couple’s chances of having a baby. “If we have more embryos to freeze, the live birth rate from the fresh embryo is significantly higher than if we didn’t have any embryos to freeze,” she says. “Why? Because more embryos means we have a better chance of selecting the best embryo.”

The findings, she hopes, will help doctors and patients to better assess their chances of pregnancy and provide more accurate information for couples about whether they should continue with IVF using their own eggs and sperm and when they should consider using donor eggs. While each couple decides on how they want to proceed with IVF, with the current findings, “at least we can give them real expectations about their chances of a live birth, so they can manage their expectations correctly and properly,” Devesa says.

TIME Retirement

This Is the Worst City to Retire In

FRANCE-ELDERLY
Philippe Huguen—AFP/Getty Images An elderly couple walks in le Touquet, northern France, on September 8 ,2013

Retirees should look to Arizona instead

If you want to retire well, set out for Arizona. According to a new Bankrate survey out Monday, the Grand Canyon state is home to three of the country’s best cities for retirees, ranked by metrics like cost of living, weather, crime rate, health care, taxes, walkability and the well-being of seniors living in the area.

“It’s just a great place for a low-maintenance, outdoor type of lifestyle,” Chris Kahn, a Bankrate analyst, told USA Today. “Your dollar is going to stretch further in Arizona.”

But where’s the worst place to call it quits? That’s New York City.

The survey’s full results for the best places to retire are as follows:

1. Phoenix metro area, including Mesa and Scottsdale

2. Arlington/Alexandria, Virginia.

3. Prescott, Arizona

4. Tucson, Arizona

5. Des Moines, Iowa

6. Denver, Colorado

7. Austin, Texas

8. Cape Coral, Florida

9. Colorado Springs, Colorado

10. Franklin, Tennessee

Meanwhile, the worst cities for retirees include the Big Apple; Little Rock, Ark.; New Haven, Conn.; and Buffalo, N.Y.

TIME Aging

This 92-Year-Old Is the Oldest Woman to Ever Run (and Finish) a Marathon

Harriette Thompson, oldest woman marathon runner
Paul Nestor—Competitor Group/AP Harriette Thompson starts the Suja Rock ‘'n'’ Roll Marathon in San Diego on Sunday, May 31, 2015

A two-time cancer survivor, Thompson has raised more than $100,000 for charity over 15 years

Finishing a marathon is difficult at any age, but if you want to know how hard it is at 92 you’ll have to ask Harriette Thompson. The Charlotte, N.C., resident completed the San Diego Rock ‘n’ Roll marathon on Sunday with an unofficial finishing time of 7:24:36, making her the oldest woman to run a competitive 26 miles and 385 yards.

Thompson took up running at age 76 and has been tackling marathons annually ever since, Runner’s World reports. She’s only missed one since then, while she was undergoing cancer treatment.

Cancer has affected Thompson’s life deeply. She lost her husband of 67 years to the disease in January and now struggles with painful wounds on her legs resulting from treatment for squamous cell carcinoma. It’s fitting, therefore, that Thompson runs her marathons to benefit the Leukemia and Lymphoma Society. In the 16 years she’s been running, she has raised over $100,000 for the organization.

Thompson’s son, Brenny, often runs with her, but this year she had more well-known company. Starting up front with the elite runners gave her the opportunity to meet Meb Keflezighi, the New York and Boston marathon winner. But during the race, Thompson herself became the celebrity. “Since I’m so old, everbody wants to have their picture taken with me. Brenny says, ‘Don’t stop her, just take a selfie,’ rather than stop and take pictures all the time, because I’d never get to the end,” Thompson told Runner’s World.

Thompson’s new record breaks the one set by Gladys Burrill, who ran the Honolulu Marathon at 92 years, 19 days old. Thompson is nearly three months senior.

[Runner’s World]

TIME Innovation

How to Fix the World Health Organization

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. Before the next Ebola strikes, we need to fix the World Health Organization.

By Julia Belluz and Steven Hoffman in Vox

2. Family leave isn’t just about caring for babies.

By Gillian B. White in the Atlantic

3. Someone should buy Yelp and use it to revive local news.

By Ken Doctor in Nieman Lab

4. What makes one of America’s oldest big cities perfect for bike-commuting?

By Sarah Goodyear in CityLab

5. How to make Twitter better.

By Marc Anthony Rosa in Medium

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME viral

This Video of a Young Couple Aging 70 Years Will Make You Laugh and Cry

Love goggles don't wear off

Young love is beautiful—but that’s the easy part. What will two people see in each other decades from now when they’re no longer much to look at?

Engaged couple Kristie and Tavis, two such specimens of young love, wanted to look into their future before they tied the knot in a month. Cut Video and Field Day gave them a chance to peek into their marriage’s crystal ball, and in 100 Years of Beauty, the couple is transformed by a team of makeup artists from attractive 20-somethings into 90-year-olds, complete with costumes and prosthetics.

Time traveling through various stages of middle and old age—50, 70 and 90—taught them a few things. Realization No. 1: start wearing sunscreen now. Realization No. 2: love goggles don’t wear off when the wrinkles set in.

“You look fantastic,” Tavis tells Kristie when she reaches age 90 in a pink nightgown. “You don’t look a day over 75.”

MONEY retirement planning

This Popular Financial Advice Could Ruin Your Retirement

two tombstones, one saying $-RIP
iStock

The notion of "dying broke" continues to appeal to many Americans. That's too bad, since the strategy is ridiculously flawed.

You may have heard of the phrase “Die Broke,” made popular by the bestselling personal finance book of the same name published in 1997. The authors, Stephen M. Pollan and Mark Levine, argue that you should basically spend every penny of your wealth because “creating and maintaining an estate does nothing but damage the person doing the hoarding.” Saving is a fool’s game, they claim, while “dying broke offers you a way out of your current misery and into a place of joy and happiness.”

I love a good contrarian argument, but for whom did this plan ever make sense? Perhaps people like Bill Gates who have so much money that they decide to find charitable uses for their vast fortune. But for the rest of us, our end-of-life financial situation isn’t as nearly pretty, and we’re more likely to be in danger of falling short than dying with way too much.

In a recent survey, the Employee Benefit Research Institute found that 20.6% of people who died at ages 85 or older had no non-housing assets and 12.2% had no assets left at all when they passed away. If you are single, your chances of running out of money are even higher—24.6% of those who died at 85 or older had no non-housing assets left and 16.7% had nothing left at all.

Now, perhaps some of those people managed to time their demise perfectly to coincide when their bank balance reached zero, but it’s more likely that many of them ran out of money before they died, perhaps many years before.

And yet the “Die Broke” philosophy seems to have made significant headway in our culture. According to a 2015 HSBC survey of 16,000 people in 15 countries, 30% of American male retirees plan to “spend it all” rather than pass wealth down to future generations. (Interestingly, only 17% of women said that they planned to die broke.)

In terms of balancing spending versus saving, only 61% of men said that it is better to spend some money and save some to pass along, compared to 74% of women. Perhaps that’s why, as a nation, only 59% of working age Americans expect to leave an inheritance, compared to a global average of 74%.

There are so many things wrong with this picture. The first is that Pollan and Levine’s formula of spending for the rest of your life was predicated on working for the rest of your life. “In this new age, retirement is not only not worth striving for, it’s impossible for most and something you should do you best to avoid,” they wrote. Saving for retirement is certainly hard, and I don’t believe that all gratification should be delayed, but working just to spend keeps you on the treadmill in perpetuity.

Besides, even if some of us say we’re going to keep working all our lives, that decision is usually dictated by our employer, our health and the economy. Most of us won’t have the choice to work forever, and the data simply don’t support a huge wave of people delaying retirement into their 70s and 80s. And as I have written before, I don’t buy into the current conventional wisdom that planning for a real retirement is irrational.

But perhaps the most pernicious aspect of the “Die Broke” philosophy is that it takes away the incentive to our working life—to get up in the morning and do your best every day, knowing that it’s getting you closer to financial security—and the satisfaction that goes with it. In the end, I believe what will bring us the most happiness is not to die rich, or die broke, but to die secure.

Konigsberg is the author of The Truth About Grief, a contributor to the anthology Money Changes Everything, and a director at Arden Asset Management. The views expressed are solely her own.

Read next: This Retirement Saving Mistake Could Cost You $43,000

TIME Aging

Why More Older Americans Are Suffering From Fatal Falls

55% of unintentional injury deaths among seniors come from falling

One of the fastest growing killers of older Americans isn’t a disease or a disability. It’s the accidental fall.

A new CDC report finds the rate of Americans aged 65 or over who die as a result of unintentional falls has nearly doubled since 2000; 55% of older citizens who die of unintentional injuries do so from falls, up from 33% in 2000. The death rate from falls increased from 29.6 per 100,000 in 2000 to 56.7 per 100,000 in 2013.

There’s no single reason for the steep increase in deaths from falls, and it’s far from clear what may be behind the rise, says the National Center for Health Statistics’ Ellen Kramarow, the report’s co-author. She notes the report is based on death certificate data, and there may be better reporting on underlying causes of death than in the past. But one factor some researchers point to is the continuing increase in overall life expectancy.

“People are living longer and living longer with conditions that make them frail and vulnerable to fall,” Kramarow says.

Before the growth in end-of-life care, assisted living facilities, medications, and hospital procedures designed to extend our lives, many people died from diseases or ailments that previously couldn’t be cured or treated in a way that made them manageable. Today, older Americans can often stave off death from something like heart disease or diabetes with medication that can prolong life longer than ever before. U.S. life expectancy is now at a record high of 78.8.

But as we live longer, often with diseases that once might have killed us, we get more frail — and consequently, researchers say, more likely to suffer fatal injuries from a fall.

Rates for other fatal accidental injuries like car crashes, suffocation, poisoning and fire-related deaths have remained steady over the last decade, according to the CDC. The death rate among seniors due to vehicle accidents actually went down in 2013 to about 15 per 100,000 people from 20 per 100,000 in 2000.

Overall, unintentional injuries resulted in almost 46,000 deaths for those 65 and older, making it the eighth leading cause of death. Unintentional injuries comprised 85% of all fatal injuries in 2012-2013 with suicide and homicide accounting for 15%.

TIME Sex/Relationships

Why Menopause Isn’t the Sex Killer You Thought It Was

200165967-002
Oppenheim Bernhard—Getty Images

A woman's sex drive isn’t as affected by menopause as we once thought

Hormones are generally at the center of any discussion about sex. At puberty, the surge in estrogen and testosterone is responsible for the emergence of a sex drive, launching the most fertile period in our lives, while at the other end, a decline in hormones means a waning libido.

But we shouldn’t be so quick to blame that change in hormones, at least in women, say researchers led by Dr. Tim Spector, professor of genetic epidemiology at King’s College, London.

In a report published in the Journal of Sexual Medicine, Spector and his colleagues studied four years’ worth of answers that women provided about their sexual health both before and after menopause. It’s the first study to analyze how various domains in sexuality, including desire, arousal, orgasm, satisfaction and pain, interact with each other and change over time.

They expected that sexual drive and problems with sexual function would increase with time and be higher among women after menopause. But the rate of sexual dysfunction over the four-year study period was about the same—22% to 23%—for both pre- and post-menopausal women. That suggests that menopause, which marks the end of a woman’s reproductive years and is biologically triggered by a decline in estrogen levels, isn’t as important a contributor to sexual issues as once thought.

“We were surprised by the results a little bit,” says Spector. “They suggest that menopause has been exaggerated as an excuse for everything.”

What’s more, the proportion of women reporting improvements in sexual function during the study also remained about the same in pre- and post-menopausal women, hinting that declines in things like desire or arousal can be reversed to a certain extent. “Women do see improvements in sexual functioning after menopause,” Spector says. “What that says is that you are not necessarily stuck” if you experience sexual dysfunction.

The best predictor of how your sex life will change, in fact, is where you start. Women reporting issues with desire, arousal or orgasm at the start of the study, for instance, were more likely to continue to have those issues at the end of the study. But, as the results show, where you start doesn’t have to dictate where you end up when it comes to sexual function. “By modifying your life and attitudes about sexual desire,” Spector says, “you can change things sometimes surprisingly for the better, although you are getting older.”

TIME A Year In Space

The Great Space Twins Study Begins

Astronaut twins Mark and Scott Kelly
Marco Grob for TIME Astronaut twins Mark and Scott Kelly

Scott and Mark Kelly—one in space, one on Earth—go under the microscope for science

When serendipity hands scientists the perfect experiment, they don’t hesitate to jump on it. That’s surely the case with NASA’s improbable study of Scott Kelly, who has just completed the first month of a one-year stay aboard the International Space Station, and his identical twin brother Mark, who will spend the same year on Earth.

Zero-gravity messes with the human body in all manner of ways but it’s not always easy to determine which problems are actually caused by the weightlessness and which would have happened anyway. The puzzle gets a lot easier if you just happen to have a second subject with exactly the same genes, the same lifestyle and the same level of fitness. Observe any differences in their health over the year, subtract the matching genetics and what’s left over on the other side of the equal sign is likely the work of weightlessness. Much of the research that will investigate these differences in the Kellys is already underway, both in space and on the ground.

One of the most important studies involves what are known as telomeres, the cuffs that protect the tips of chromosomes in much the way a plastic aglet protects the tips of shoelaces. The longer we live, the shorter our telomeres get, and the unraveling of the chromosomes that results drives the infirmities that come with age.

“One of the things that comes up almost all the time in the interviews with Mark and Scott is this idea of the twin paradox,” says Susan Bailey, of Colorado State University, who is coordinating the telomere research. “Is the space twin going to come back younger than the Earth twin?” That kind of time dilation happens in movies like Interstellar, but only when someone is moving at close to light speed. The year Scott will spend orbiting Earth at 17,500 mph (28,000 k/h), may indeed slow his body clock, but by barely a few milliseconds. His telomeres, however, will more than make up for that, and he’ll likely come home physically older than Mark.

“A whole variety of life stresses have been associated with accelerated telomere loss as we age,” says Bailey. “You can imagine strapping yourself to a rocket and living in space for a year is a very stressful event.”

Chromosomal samples from both Kelly twins were taken and banked before Scott left to provide a telomere baseline, and more samples will be collected over the year. Mark’s are easy enough to get ahold of, but Scott will have to draw his own blood in space, spin it down and freeze it, then send it home aboard returning ships carrying cargo or astronauts. Both twins will also be followed for two years after Scott comes back to determine if any space-related telomere loss slows and if the brothers move closer to synchrony again.

The twins’ blood samples will also be used to look for the state of their epigenomes, the chemical on-off switches that sit atop the genome and regulate which genes are expressed and which are silenced. Environment is a huge driver in epigenetic changes, especially in space, as cells adjust to the unfamiliar state of weightlessness. “We can kind of build these molecular maps of what’s happening in the different cells…as they’re challenged by this low gravity condition,” says geneticist Chris Mason of Weill Cornell Medical Center in New York City, who is leading this part of the work.

Also due for a good close look are Scott’s and Mark’s microbiomes. The number of cells that make up your body are actually outnumbered 10 to one by the bacteria, viruses, yeasts and molds that live in your body. It’s only the fact that most of them are also much smaller than human cells that prevents them from outweighing you 10 to one as well. Still, if you could extract them all and hold them in your hand they’d make a hot bolus of alien organisms weighing up to 5 pounds.

This is actually a good thing, since we need this interior ecosystem to keep our bodies—especially our digestive tract—running smoothly. Like so much else for Scott, that will change in space. “A significant part of what’s present normally in the gastrointestinal tract doesn’t actually colonize,” says research professor Martha Vitaterna of Northwestern University, co-investigator on the microbiome work. “These are things that are constantly being reintroduced with fresh fruits and vegetables, and that’s missing from Scott’s diet.”

Genes can also make a difference to the microbiome, since any individual’s genetic make-up may determine which microorganisms thrive in the gut and which don’t. Scott’s and Mark’s microbiomes will be compared throughout the year, principally through stool samples—ensuring some unglamorous if scientifically essential shipments coming down from space.

Other studies will involve the way body fluids shift in zero-g, drifting upwards to the head and elsewhere since there is no gravity pulling them down. This can damage vision as a result of pressure on the eyeballs and optic nerve. It can also lead to damage to the cardiovascular system, with astronauts returning to Earth at increased risk of atherosclerosis.

Some of these changes can be tracked by blood studies, which will look for proteins that regulate water excretion. Ultrasound scans can also look for vascular damage. Before leaving Earth, Scott had a few small dots tattooed on his upper body to indicate the exact points at which he has to position the ultrasound probe—easier than taking precise measurements to find the proper spots every time he’s due for a scan.

Multiple other studies will be conducted on the twins as well, looking at their immune systems, sleep cycles, psychological states and more. For years, space planners have been talking a good game about going to Mars one day, but those trips will last more than two years. We know the hardware can survive the trip; what we don’t know is if the human cargo can. A year from now—thanks to the Kellys—we’ll be a lot smarter.

TIME is covering Kelly’s mission in the new series, A Year In Space. Watch the trailer here.

TIME Longevity

Scientists Discover the Secret to Keeping Cells Young

Nude mature woman with grey hair, back view.
Getty Images

Researchers say it may be possible to slow and even reverse aging by keeping DNA more stably packed together in our cells

In a breakthrough discovery, scientists report that they have found the key to keeping cells young. In a study published Thursday in Science, an international team, led by Juan Carlos Izpisua Belmonte at the Salk Institute, studied the gene responsible for an accelerated aging disease known as Werner syndrome, or adult progeria, in which patients show signs of osteoporosis, grey hair and heart disease in very early adulthood.

These patients are deficient in a gene responsible for copying DNA, repairing any mistakes in that replication process, and for keeping track of telomeres, the fragments of DNA at the ends of chromosomes that are like a genetic clock dictating the cell’s life span. Belmonte—together with scientists at the University Catolica San Antonio Murcia and the Institute of Biophysics at the Chinese Academy of Sciences—wanted to understand how the mutated gene triggered aging in cells. So they took embryonic stem cells, which can develop into all of the cells of the human body, and removed this gene. They then watched as the cells aged prematurely, and found that the reason they became older so quickly had to do with how their DNA was packaged.

MORE: The Cure for Aging

In order to function properly, DNA is tightly twisted and wound into chromosomes that resemble a rope in the nucleus of cells. Only when the cell is ready to divide does the DNA unwrap itself, and even then, only in small segments at a time. In patients with Werner syndrome, the chromosomes are slightly messier, more loosely stuffed into the nuclei, and that leads to instability that pushes the cell to age more quickly. Belmonte discovered that the Werner gene regulates this chromosome stability. When he allowed the embryonic stem cells that were missing this gene to grow into cells that go on to become bone, muscle and more, he saw that these cells aged more quickly.

“It’s clear that when you have alterations in [chromosome stability], the process of aging goes so quickly and so fast that it’s tempting to say, yes, this is the key process for driving aging,” says Belmonte.

Even more exciting, when he analyzed a population of stem cells taken from the dental pulp of both younger and older people, he found that the older individuals, aged 58 to 72 years, had fewer genetic markers for the chromosome instability while the younger people aged seven to 26 years showed higher levels of these indicators.

MORE: What Diet Helps People Live the Longest?

“What this study means is that this protein does not only work in a particular genetic disease, it works in all humans,” says Belmonte. “This mechanism is general for aging process.”

Before it can be considered as the Fountain of Youth, however, Belmonte says new and better techniques need to be developed that can more specifically and safely alter the Werner gene in people, not just a culture dish of human cells. He also stresses that there may be other processes contributing to aging, and it’s not clear yet how important chromosome stability is compared to those factors. But, he says. “having technologies like this will allow us to determine how important each of these parameters are for aging.” And if the findings hold up, they could be first step toward finding a way to help cells, and eventually people, live longer.

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