Harley Street Clinic’s Dr Geetha Venkat: What you need to know about age and fertility
Fertility and age: knowing where you stand There is no denying that the age in which women are having their first baby has and continues to
But from some of the information out there, it seems like getting pregnant naturally after 40 is as rare as winning the lottery!
Articles warn of the ‘steep decline’ in female fertility after 35, and GPs warn that delaying motherhood can result in disappointment. However, that doesn’t seem to stop celebs, as many famous women have had babies into their late 40s, 50s, and even their 60s!
While fertility does indeed decline, there are also plenty of studies and anecdotes that highlight the benefits of waiting until you’re older. After all, your finances are more stable, you’re a more mature parent with more life experience, and you’re in a better headspace, all of which benefit your child immensely.
So, what does the science say? If you’re planning to start trying to conceive after the age of 40, this article is for you.
According to the American College of Obstetricians and Gynecologists, female fertility starts to decrease after 32. By the time a woman reaches the age of 37, her fertility begins to decrease even more rapidly. Similarly, male fertility does also decrease with age. Even though many men remain fertile into their 60s and later, the likelihood of birth defects and miscarriage also increases with paternal age.
Of course, all hope is not lost! Many women in their 40s conceive naturally. According to the British Fertility Society chair, Dr Jane Stewart, “about 50% of women who try to conceive naturally in their early to mid-40s will achieve a pregnancy.” However, the success rates are only around 5% per cycle.
“Having said that, if you look at women under 38, that’s women with normal fertility – so ovulating regularly, in good health, their partners producing normal sperm levels and having regular intercourse – 95% of them will conceive within two years, whereas half of the women trying in their 40s won’t conceive at all. So, trying a bit younger does make a difference.”
So, as you can see, while fertility does decline in your late 30s, it’s still very possible to conceive naturally after the age of 40. But for those who are trying to have a baby, 50% may not be the most reassuring figure. Read ahead to learn more about why women’s fertility decreases – and what you can do to improve your chances of success.
While many women and AFAB (assigned female at birth) people can easily get pregnant well into their 40s, others face additional problems that younger women may not have to deal with as they try to conceive.
Egg Quality
Egg quality begins to decrease in many women after the age of 35. As a result, a higher number of eggs will be unviable, having chromosomal abnormalities that could lead to poor implantation and miscarriage. As women in their 40s have lower egg quality, it can take more cycles to become pregnant. This decline in quality has led to many women choosing to freeze their eggs while they’re still in their 20s and 30s.
Diminished Egg Reserve
A low egg reserve (or ovarian reserve) refers to the number and quality of the potential eggs that remain in a woman’s ovaries. The normal ageing process causes diminished egg reserve, but some women also experience this problem due to genetic defects, medical treatments, and injury. A low egg count (measured by testing your AMH (anti-Mullerian hormone) levels) can also signal low egg quality
Perimenopause and Menopause
Most women go through the menopause around the age of 51, but some women experience the change much earlier. It’s helpful to ask your mother what age she went through the menopause, as it can be genetic. Many women start going through perimenopause as early as their late 30s, causing them to ovulate less regularly. While pregnancy during perimenopause is possible, it dramatically reduces your chances.
Of course, you can still have a baby during or after the menopause via IVF using donor eggs or eggs that you froze when you were younger. That said, there are increased risks when carrying a pregnancy after menopause – you will need to take hormonal medications to prepare your uterus.
Fibroids
Women are more prone to fibroids, non-cancerous growths in the uterus, as they get older. While it is still possible to have a normal, healthy pregnancy with fibroids, they can negatively impact conception in up to 10% of all women.
If you are successful, it’s important to be aware that older mothers tend to have more problems in their pregnancies. These problems can include high blood pressure, pre-eclampsia, and gestational diabetes. Sadly, miscarriage is also more common.
According to Dr Stewart, “in your 40s, you’ve got about a 40-50% chance of miscarriage each time you get pregnant.” The risks of having a baby with Down’s Syndrome also increase with maternal age. “At 40 your risk of having a baby with Down’s syndrome is about 1 in 100; at 45, it’s 1 in 50.”
However, even with these increase numbers, many older mothers have successful pregnancies. Dr Stewart says, “the risks are higher, but many women will go on to have healthy babies.”
In theory, getting pregnant naturally after 40 is the same as conceiving when younger! For heterosexual couples, it’s essential to have penetrative sex during the woman’s fertile window, which includes the few days leading up to ovulation and the day of ovulation itself. For gay, lesbian, and other queer couples, getting pregnant may involve fertility treatments right from the outset.
Here are a few steps that heterosexual couples can follow to try to conceive naturally.
If you’re trying and failing to conceive after the age of 40, it can be a lonely and stressful experience. If you have been trying to conceive for more than six months without success, visit your GP. They can order preliminary testing and refer you to your council’s fertility service.
However, it’s important to note that some NHS commissioning groups will only allow one cycle of IVF for women over the age of 40. It often takes multiple rounds of IVF to successfully become pregnant, so any further cycles will need to be self-funded. You also need to have an ovarian egg reserve that is high enough to produce multiple eggs during hormonal stimulation. If you have a low egg reserve, you may need to consider donor eggs for IVF.
Getting pregnant after 40 is possible, and many people go on to have happy, safe, and healthy pregnancies. In fact, most people are glad they waited until later in life so they can provide their child with the benefits of their education, stable finances, and life experience.
Fertility and age: knowing where you stand There is no denying that the age in which women are having their first baby has and continues to
Trawling through articles recently I (Tracey) came across one by Zita West about one of the most common questions she gets asked. ‘How long I
“Women should wait no later than 28 to start trying to have children”, said Professor Adam Balen, the former chairman of the British Fertility Society, and
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