13 June 2018

Age and fertility: How easy is getting pregnant in your 40s?

By the Editorial Comitee IVI Blog



A common question we encounter at IVI concerns getting pregnant in your 40s. Sometimes people wonder if it is even possible. The simple answer is yes. Although it can be more difficult, getting pregnant at 41, 42, and even at 45 is possible! However, it’s a fact of nature that fertility declines as the years go by. There does come a point in a woman’s life when natural conception becomes increasingly unlikely. So while it is possible to get pregnant after 40, it is not the norm. If natural conception is extremely unlikely or not feasible due to age, with modern fertility techniques, you can even get pregnant at 50 or after menopause.

Why does fertility decline with age?

Age does not absolutely define fertility and, of course, every woman is different. In general, fertility does decline over time, though it is not simply predicted by calendar years. In females from the age of 35 onwards, reproductive potential drops and after the age of 40 there is less than a 10% chance of becoming pregnant naturally in any given month. The reason for this declining fertility, which reduces the chances of pregnancy and inexorably continues to reduce even further the likelihood of becoming pregnant in your 40s, is all in the arithmetic.

Girls are born with all the eggs they will ever have. At birth, they number just over a million. By puberty, between 300,000 and 500,000 eggs remain in the ovaries. However, from this very prolific starting point, only around 300 eggs will be ever fully mature and be released during ovulation. So naturally as you age, the number of remaining eggs declines. And as menopause approaches, the ovaries become less responsive to the hormones responsible for triggering ovulation. This is why, although we may all have heard anecdotes about a friend of a friend who was surprised to be pregnant at 45, the odds are against this happening.

How can I increase my chances of getting pregnant in my 40s?

If you’re wondering how to get pregnant after 40 years old, healthy living is essential. Eating a healthy diet, taking regular exercise, maintaining a healthy weight and not smoking will help to keep you in good health and give you the best chance of conceiving. Since the calendar is already working against you when you are hoping to conceive, by practising healthy living you can help improve your chances of successful conception and the birth of a healthy baby. However, you should also check with your doctor or clinician to see whether there is any other underlying cause of infertility. In 30% of cases there is a male factor involved, in 30% the cause is a female factor and sometimes it is not possible to pinpoint a precise cause.

The main causes of fertility problems in women, apart from age-related decline, are damage to one or both of the fallopian tubes and endometriosis, in which cells that are normally found in the lining of the womb lie outside the womb. Other risk factors include fibroids, sexually transmitted infections such as chlamydia, chronic conditions such as diabetes, cancer, thyroid disease, asthma or depression, and taking some specific medications such as antidepressants.

Are there any problems inherent in being pregnant at 45?

If you are pregnant any time in your 40s, there are certain risks to you. Statistically, you are more likely to experience a miscarriage, have high blood pressure or placenta praevia. These dangers can be watched for and mitigating action taken as long as you have the right level of antenatal care. There are also risks for your baby, the main one being an increased risk of chromosomal abnormalities. At IVI fertility clinics we screen for these risks, thereby reducing the risk.

When should I decide to seek fertility treatment?

If you are a woman over the age of 35, you could experience a decrease in your fertility as it declines as you age. If you are in this age bracket, or more, and you have been trying to conceive naturally without success for six months, it is time to see a doctor. Six months may seem like a short time, but the sooner you seek help, the higher the chances of success. Making the call for a consultation is not easy and we do understand that the first step can seem a little daunting. However, at IVI we’re here to help and to let you know that you’re not alone. Our dedicated team of specialists is ready to answer any questions and make sure that your experience of IVI lives up to your expectations. You can get an idea of what to expect by having a look at our step-by-step guide to the IVF process.

Help for those who want to know how to get pregnant after 40 years old: what types of treatment are available?

For those looking to get pregnant at 45, at 50 or even after menopause, you need to understand the nature of the assisted reproduction treatments that are available through IVI.

Can I get pregnant at 45? The fertility preservation option

Recommended for younger women who wish to delay parenthood for career, social or medical reasons, fertility preservation involves freezing and storing eggs, sperm, or embryos. These techniques for preserving fertility offer women flexibility concerning their own fertility decisions and freedom of choice over when to become a mother. These treatments can also be used to ensure that patients are able to have children after completing treatments for cancer that may affect their fertility. This is also a treatment that we recommend in the case of patients at risk of losing ovarian function: for example, women who are due to undergo chemotherapy or radiotherapy treatment, and women who may need repeated ovarian surgery, for example, to treat endometriosis.

Help with becoming pregnant at 42: IUI

While natural conception is possible around age 42, one of the simplest assisted fertility procedures can increase the chances. IUI is one of the most straightforward forms of treatment. Sperm, either from the male partner or a donor according to individual circumstances, is prepared in the laboratory and placed directly into the woman’s uterus.

Help with becoming pregnant in your 40s: IVF

In Vitro Fertilisation (IVF) is the most well-known assisted reproduction technique. It is a very well-established procedure in which embryos are created by fertilising the egg with the sperm in a laboratory. The resulting embryos are then transferred to the woman’s uterus. There are two ways of conducting this procedure. The fertilisation process may be carried out with conventional IVF in which the sperm and egg are mingled together in a culture plate, or else via ICSI, which consists of inserting a live spermatozoon into the oocyte by puncturing it with the aid of a pipette.

There is also the option of IVF plus PGS (Preimplantation Genetic Screening) which has the advantages of reducing the chance of miscarriage and increasing the success rate per embryo transfer.

Can you get pregnant after menopause?

There are ways in which assisted reproduction can help to achieve a successful pregnancy even around or after the menopause. This is an option for women looking to get pregnant at 50. Egg donation is the treatment we recommend for women with ovarian failure due to menopause (either premature or at the usual age of around 50) or ovarian surgery. There are other circumstances where this would also be the recommended treatment, including for women who cannot use their own oocytes for any reason and women who have repeatedly failed to become pregnant through IVF.

How does egg donation work?

Egg donation is the process whereby oocytes from a donor are combined with spermatozoa, either from the male partner or from a donor, to achieve the desired pregnancy. This technique can make the miracle of parenthood possible for women who would not be able to have children any other way.

Naturally, when a woman at or around menopause is seeking this form of assisted reproduction, time is of the essence and unfortunately in some countries, there can sometimes be lengthy waiting lists. At IVI clinics in Spain, egg donation is more prevalent. The regulatory regime requires that donors should be between 18 and 35 years old, that their genetic history meets the legislative standards and they have a normal reproductive system. Chromosomal checks also guard against the possibility of future defects and transmissible diseases. In Spain egg donation is voluntary and anonymous and, at IVI clinics, we do not reveal the identity of donors or recipients, while retaining information needed for monitoring the pregnancy such as blood group of the donor.

Find out more about the IVI egg donation programme

If you think this could be the way for you to see your dream of parenthood come true, have a look at our video about our egg donation programme, or get in touch with IVI using our contact centre. We’re here to help.





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