Getting Pregnant After 40: Difficulty, Risks, and How to Conceive

by Jul 14, 2020

Most of us have heard about our biological clocks and perhaps some of you have felt it ticking away. Even so many women are waiting until later in life to start a family. So how difficult is it to get pregnant after 40?

woman keeps a gift

How does fertility change as you age?

Although it is now possible to have a healthy pregnancy later in life, your chance of conceiving (especially naturally) decreases as you age. According to The American College of Obstetricians and Gynecologists (ACOG) fertility gradually decreases as you age and then begins to rapidly decrease after about the age of 32. During puberty the average woman has 300,000 to 500,000 eggs. By age 37 that number is reduced to 25,000 and by age 51 most have 1,000 or fewer eggs.

Not only do women experience a decrease in the number of eggs, but they often see a decrease in egg quality as well.

How to conceive after 40

Conceiving naturally after the age of 40 is very difficult and according to the ACOG it is nearly impossible to get pregnant naturally after age 45. To increase your chances of conceiving you need to utilize all the information available to you.


Since you have fewer eggs to possibly fertilize it is important to understand your cycle and time intercourse appropriately. Using a fertility tracker such as Mira allows you to find your fertile window and map out a plan to increase your odds of conceiving. It is important to use an advanced tracker that measures hormone levels to pinpoint ovulation. As you age, your cycle adjusts and you may ovulate earlier in your cycle than when you were younger. Therefore, using a calendar method that calculates days from your period might not accurately predict your most fertile days.

If you are looking to conceive after 35 there are several things you can do to increase your chances of conceiving naturally:

  • Talk to your doctor before trying to conceive
  • Review medications and conditions that might reduce your chances
  • Use an advanced fertility tracker to measure hormones
  • Maintain healthy habits
  • Reduce stress

If you have been trying for six months and have not successfully conceived it may be time to talk to your doctor about seeing a fertility expert. A specialist will be able to run the appropriate tests to check for factors affecting your ability to conceive.

It is common for women over 35 to seek out fertility treatment and you should talk to your doctor about all of your options to find the one that is best for you. The most common treatments include:

  • Fertility drugs such as clomiphene citrate may be used to stimulate follicle development and ovulation.
  • In vitro fertilization (IVF) with ovarian stimulation. This treatment uses fertility medications to produce multiple eggs and then your eggs are fertilized with your partner’s sperm in the lab and transferred back into your uterus.
  • IVF with donated eggs. This treatment uses an egg donation from a younger woman and then transfers the fertilized egg back into your uterus. Many specialists have found a higher rate of success with this treatment versus using older eggs.

Risks of pregnancy after 40

For years the recommendation was to have children before the age of 35 for both the health of the baby and the mother. With advances in medicine and technology the risk of pregnancy later in life is reduced, but it still comes with increased risks of:

  • preeclampsia
  • Birth defects, such as Down syndrome
  • Miscarriage
  • Low birth weight
  • Ectopic pregnancy
  • Gestational diabetes

Prior to conceiving it is important to review these risks and any other factors related to your health with your doctor. If you do become pregnant it will most likely be a completely different experience than if you were younger. You will probably experience more aches and pains during the pregnancy and increased fatigue.

Also, it is important to remember that labor and delivery might be different than you expected due to your age. Given your increased risk for preterm labor, preeclampsia, and other possible complications you might not be able to deliver vaginally. Discussing delivery and alternative plans should a problem arise will help reduce stress on you and give you and your baby every chance at a healthy birth experience.

Although the chances of becoming pregnant past the age of 35 are reduced it is not impossible. More women are putting off becoming a parent for personal reasons and experiencing healthy pregnancies at older ages. Finding the right time in your life to become a mother is important. Whatever age you decide is right for you, seek out the tools and treatments that will help you create your family in a healthy way.

✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG

Banafsheh Kashani, MD, FACOGBanafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training. 

Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.

Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).

Order Your Mira Today

Ready to easily, precisely, and automatically track your ovulation cycles? Let Mira take the guesswork out of getting pregnant, so you know exactly when to conceive.

Reserve Your Mira Today

Ready to easily, precisely, and automatically track your ovulation cycles? Let Mira take the guesswork out of getting pregnant, so you know exactly when to conceive.

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