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

We’ve all heard about our so-called “biological clocks” – and if you’re already in your late 30s, you may be feeling like yours is rapidly ticking away. But despite pressure from family, friends, and society to have children ASAP, it’s important to recognize that it’s still possible to have a healthy pregnancy even in your 40s. 

Read on to learn about the challenges, risks, and effective strategies to enhance your chances of conceiving.  

Explanation of How Fertility Declines With Age

Ovulating individuals are born with a set number of eggs, and the quantity of these eggs decreases with age.

For example, during puberty, an individual has 300,000 to 500,000 eggs. By age 37, this number decreases to 25,000 eggs — and by age 51, most individuals have fewer than 1,000. Unfortunately, because not all of these eggs will be healthy enough to support a pregnancy, the “true” number of viable eggs is much lower than that.

With fewer viable eggs available, this can make getting pregnant in the first place a challenge for many couples. For some, getting pregnant will require careful fertility planning, monitoring, and even extra help from assisted reproductive technologies (ARTs).

Your ovarian reserve refers to your reproductive potential based on the number of healthy, viable eggs left in your ovaries.  A blood test checking your anti-mullerian hormone (AMH) can help determine your ovarian reserve.  AMH is produced by the follicles where eggs develop and steadily declines throughout your reproductive lifespan. The lower your AMH level is, the fewer eggs you have in your ovarian reserve.  

AMH levels decrease with age alongside egg count, so if you are trying to conceive it is an important hormone to track.  You can get your AMH levels tested by a doctor or using an at-home test.  Mira’s own Fertility Panorama Lab Test measures AMH levels along with several other key fertility hormones including thyroid stimulating hormone (TSH), Free Thyroxine (fT4), Prolactin, and Free Testosterone.  

Statistics on Fertility Rates For Women Over 40

Factors Contributing to Decreased Fertility

There are a number of factors that contribute to decreased fertility.  With fewer viable eggs available, it can make getting pregnant in the first place a challenge not to mention the change in egg quality.  

When we are young, some of our eggs will have genetic abnormalities, but most of them will be healthy. However, by age 40, this ratio flip-flops, leaving us with more genetically abnormal eggs than healthy ones. Experts estimate that after age 40, less than half of a woman’s eggs are considered “normal.”

Risks Associated with Pregnancy After 40 

Increased Risk of Miscarriage

Miscarriage statistics show that the risk of miscarriage in individuals over the age of 40 is nearly 50%, more than triple that of individuals in their 20s. Most miscarriages occur because of abnormalities in the fetus, many of which are genetic. It’s estimated that half of all miscarriages are caused by extra or missing chromosomes.

These problems usually occur by chance when cells duplicate as the embryo grows, rather than genetic abnormalities inherited from a parent. Unfortunately, these errors appear to become more common as egg quality declines with age.

Higher Likelihood of Chromosomal Abnormalities

As we age, the risk of an egg having a genetic abnormality increases, and therefore, the risk of having a pregnancy with a birth defect also increases. 

One of the most well-known birth defects affecting the chromosomes is Down syndrome. By the age of 40, the odds of giving birth to a baby with Down syndrome are 1 in 70; by age 45, the odds increase to 1 in 19.

Greater Chance of Pregnancy Complications

If you are in the high risk pregnancy age category, you likely know that there is a greater chance of pregnancy complications.  Although these complications are more likely to occur in an advanced maternal age pregnancy (i.e. geriatric pregnancy), they won’t necessarily happen to you but it’s important to know what to watch for.  You are at a greater chance of high blood pressure, diabetes, placental issues, and birth complications when you are pregnant at 40.  

Another fun factor of being pregnant at 40 is that you are at a higher risk of multiples.  As you get older, your body starts to release multiple eggs, thereby increasing the risk for being pregnant with multiples.  

How to Increase Chances of Conception After 40

Lifestyle Changes to Boost Fertility 

If you are actively seeking to plan a pregnancy after 40, it’s worth taking stock of your lifestyle and health situation. This will empower you to make any necessary lifestyle changes to help maximize your chances of conception.  

In our post on lifestyle factors that influence your fertility you can read more about those factors and what you can do to address them.   

Importance of a healthy diet and regular exercise

A healthy diet and regular exercise can impact your hormones and ovulation patterns and even the likelihood of conceiving.  Not to mention, getting and staying healthy can impact the health of your baby in its early phases of development.  Lifestyle changes can be helpful both for preconception and once you are pregnant.  

Stress management techniques

When we’re stressed, it can wreak havoc on our biological systems, including our fertility.  Whether that’s a lower sex drive, weakened immunity, or a hormonal imbalance stress and fertility are intimately connected.  Practical ways to manage stress include exercise, journaling, yoga, or even meditation and mindfulness.   

Avoiding harmful substances (smoking, alcohol)

Obvious unhealthy habits like smoking and drinking can have an adverse effect on your fertility.   Most doctors recommend eliminating alcohol and quitting smoking, as well as cutting back on your caffeine levels and getting a jump on prenatal vitamins to get the essential minerals and vitamins you need and reduce the risk of certain birth defects.       

Medical Assistance and Fertility Treatments 

Overview of fertility treatments (IVF, IUI, egg donation)

Chances of conception after the age of 35 are higher with the help of assisted reproductive technologies (ARTs) – such as in-vitro fertilization (IVF) and intrauterine insemination (IUI), and egg donation.   

IUI is a fertility procedure where concentrated motile sperm are inserted directly into the uterus.  IUI may be performed with or without drugs used to stimulate ovarian reserves.  

IVF is a five-step process that includes diagnostic testing, stimulation of the ovaries, egg retrieval, fertilization in a laboratory, and embryo transfer.  

Egg donation is a process that uses eggs donated by someone else for you to achieve your pregnancy goals.  For those who can’t use their own eggs, this allows them to achieve their dreams of pregnancy.  

Success rates of fertility treatments for women over 40

IVF, IUI, and egg donation can increase your chances of getting pregnant but they aren’t a 100% guarantee.  Age plays a huge factor when it comes to IVF success.

According to CDC data, women under the age of 35 have the most success, but between the ages of 35 and 37 there is also a 40.5% rate of success.  Women between the ages of 38 and 40 have a lower success rate at 26.4% while those over 40 have the lowest success rate at 8.5%.  If IVF is something you are seriously considering, timing is everything.  

Not only do you need to know when you are most fertile, but also when to have sex and how often to have it.  If you have a regular cycle, ovulation tracking devices like Mira can help you recognize your LH surge and quickly identify and understand your full fertile window.  With numerical hormone readings it takes the guesswork out of fertility.  This is especially helpful if you have irregular cycles and have trouble recognizing when you are most fertile.    

Natural Methods to Enhance Fertility 

Tracking ovulation and understanding fertile windows

Tracking your cycle means knowing when you’re most fertile and when to have sex to maximize that fertility.  With Mira’s Clarity Kit, you can track 4 key fertility hormones to get a complete view of your fertility.  You can predict and confirm ovulation and know your exact fertile window with the Mira Max wands.  While with the Mira Ovum wands you can test for follicle stimulating hormone (FSH).  As your ovaries start producing less estrogen and progesterone, FSH levels increase significantly making it an important biomarker to see how far you are from menopause.     

Please note: only a healthcare professional can diagnose menopause. 

If you are approaching the high risk pregnancy age and feel that you need a bit of guidance, Mira’s own Hormone Health Coaches can help!  All of our coaches have field experience in fertility and they can help assess your symptoms, analyze your hormone tests, and provide practical fertility guidance to help you achieve your goals.  

Herbal supplements and vitamins

Your body needs certain nutrients to support physiological processes like ovulation, fertilization, and implantation so it makes sense that having adequate levels would have a beneficial effect on fertility.  

Vitamins and supplements that promote reproductive health usually contain a variety of nutrients that can also boost your chances of conception.  Many of these nutrients can be obtained through a balanced diet but no diet is perfect all the time so supplements like Mira’s prenatals can help fill in the gaps.  Mira’s Prenatal Multi-Vitamin is packed with essential ingredients that help promote reproductive wellness at every stage of the fertility journey.    

Another popular method for boosting your chances of conception is drinking fertility tea.  While the science is ongoing for their effectiveness, there is a growing body of literature behind the individual ingredients commonly found in these teas and how they may be beneficial for your fertility and overall health.   

Mira’s Fertility Tea helps promote reproductive wellness, hormone balance, and overall health.  With a blend of ingredients designed to naturally support your fertility, this tea also contains high levels of antioxidants, folic acid, and vitamins A & C.   

Acupuncture and alternative therapies

Many people turn to acupuncture or alternative therapies when they are struggling and can’t find answers.  There is preliminary research to show that acupuncture can be an effective treatment for infertility.  When combined with other western medicine methods, it may boost your chances of conception.  

Conclusion

As more and more individuals wait until they are older to have children, it can be helpful to understand the difficulty and risks of getting pregnant at an advanced maternal age (i.e. geriatric pregnancy).  

It’s important to note that these risks are only something to be mindful of – not afraid of. It is absolutely possible to conceive, carry, and deliver a healthy baby in your late 30s and 40s. In fact, advanced maternal age (AMA) birth rates in the US have actually steadily increased over 

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