Ten Facts On Pregnancy After 45
Today it has become increasingly common for women to achieve their educational goals, find a partner, and establish a career path before they consider having children. It often takes years to obtain these goals–years which include a woman’s most fertile period from age 15-30. Women who begin trying to concieve between the ages of 35 45 will have to face the fact that their fertility has already started to decline. In previous blogs, I have discussed the fact that after age 40, fertility declines precipitously, and have described treatment options for this age group. But what about women seeking pregnancy after 45? What are the treatment options available? How risky are these pregnancies?
Here are the top 10 facts about pregnancy after 45:
Will My Baby Be Disabled
An over-40 pregnancy does come with increased chances of disability for the baby in addition to risks for the mother. The prevalence of chromosomal abnormalities in babies increases with the increasing age of the mother. There are several theories as to why this may be, including a decreased number of normal oocytes available, or accumulated stress on the DNA strands within eggs, to name just a couple. At the age of 33, the chance of your baby being diagnosed with trisomy 21 during pregnancy is approximately 1/400. At the age of 40, this chance increases to 1/70. By age 45, this chance is about 1/19.
So too does the chance of congenital disabilities increase with age. The U.S. National Birth Defects Prevention Study found that women greater than age 40 are at increased risk of having babies with multiple types of heart defects, genital abnormalities, skull deformities, and esophageal malformations.
Understanding Your Odds Of Pregnancy By Age
Haley Fritz
Banafsheh Kashani
MD, FACOG
From your doctor asking if youre thinking about getting pregnant soon to nosy relatives asking when youre going to settle down, you may have felt your biological clock counting down already. With all the pressure placed on women to have a baby by a certain age, it can be easy to feel like your fertility is a ticking time bomb.
Thankfully, age does not necessarily limit your fertility as much as you may think. More and more women are choosing to wait until their 30s and 40s to have a child for reasons like pursuing career goals, traveling the world, or finding the right partner.
Still, that does not mean that your fertility is an unlimited reserve. While its becoming more common and, thanks to modern medical technology, safer to have children at an older age, your fertility still changes significantly as you get older. Heres what you need to know to understand your odds of pregnancy by age.
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Ovulation And The Menstrual Cycle
During their reproductive years, women have regular monthly menstrual periods because they ovulate regularly each month. Eggs mature inside of fluid-filled spheres called follicles. At the beginning of each menstrual cycle when a woman is having her period, a hormone produced in the pituitary gland, which is located in the brain, stimulates a group of follicles to grow more rapidly on both ovaries. The pituitary hormone that stimulates the ovaries is called follicle-stimulating hormone . Normally, only one of those follicles will reach maturity and release an egg the remainder gradually will stop growing and degenerate. Pregnancy results if the egg becomes fertilized and implants in the lining of the uterus . If pregnancy does not occur, the endometrium is shed as the menstrual flow and the cycle begins again. In their early teens, girls often have irregular ovulation resulting in irregular menstrual cycles, but by age 16 they should have established regular ovulation resulting in regular periods. A womans cycles will remain regular, 26 to 35 days, until her late 30s to early 40s when she may notice that her cycles become shorter. As time passes, she will begin to skip ovulation resulting in missed periods. Ultimately, periods become increasingly infrequent until they cease completely. When a woman has not had a menstrual period for 1 full year, she is said to be in menopause.
Where To Get Help
- Harris I, Fronczak C, Roth L, et al. 2011, Fertility and the aging male ‘, Reviews in Urology, vol. 13, no. 4, pp. e184e190.
- McGrath J, Petersen L, Agerbo E, et al. 2014, A comprehensive assessment of parental age and psychiatric disorders ‘, JAMA Psychiatry, vol. 4081, epub.
- Schmidt L, Sobotka T, Bentzen JG, et al. 2012, Demographic and medical consequences of the postponement of parenthood ‘, Human Reproduction Update, vol. 18, no. 1, pp. 2943.
- Steiner AZ, Jukic AM 2016, Impact of female age and nulligravidity on fecundity in an older reproductive age cohort‘, Fertility and Sterility, vol. 105, no. 6, pp. 15841588.
- Biro MA, Davey M-A, Carolan M, Kealy M 2012, Advanced maternal age and obstetric morbidity for women giving birth in Victoria, Australia: A population based study ‘, The Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 52, no. 3, pp. 229234.
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Questions To Ask Your Doctor
Even with the risks, some 17 percent of pregnancies in the United States are to mothers who are over 35. So, if youd like to explore this route, consider making an appointment with your doctor to discuss the benefits and risks.
Some questions to ask your provider:
- What preexisting conditions might impact my odds of getting pregnant or carrying a healthy baby to term?
- What types of lifestyle changes might improve my fertility?
- What timing tricks or treatments might increase my chances of conceiving quickly?
- How soon should I seek help for infertility?
- Besides a prenatal vitamin, what supplements might help with my fertility ?
- What ART procedures might you recommend if were unable to conceive naturally? What are the associated costs?
- What types of prenatal testing are available to me to screen for chromosomal abnormalities? And what are the risks of testing?
- What options are available if abnormalities are discovered?
You might also want to ask if certain preconception testing might be helpful. You can get blood tests that check your hormone levels, thyroid function, and ovarian reserve . Other tests can check for any abnormalities or damage to the reproductive organs themselves, like the uterus and fallopian tubes.
And some doctors may suggest you meet with a genetic counselor to discuss your risks of carrying a baby with chromosome issues/genetic disorders.
Benefits Of Having A Baby After 40
While having a child when you’re older comes with challenges, there are also some unique benefits to being a parent later in life.
Some possible benefits of having a baby after 40 include:
- You might be more emotionally prepared. Being older does not always equate with maturity, but many people feel more emotionally settled by this point in their life. If you’re in a supported, strong, emotional place, you’ll be better prepared for the ups and downs of pregnancy, birth, and child-rearing.
- You might have more financial stability.After several decades of working, saving, and investing, the cost of raising kids might not feel as overwhelming as it did when you were younger.
- You might be more ready to focus on family. By midlife, you’ve probably checked off a lot of goals, from education and career to travel and forming lasting relationships with others. You may feel free to be more focused on building a family. You might have a home of your own or at least be settled into a community that you care about. If you have a partner, you’re hopefully feeling secure and stable in your relationship and are excited about parenting with them.
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What Are The Risks To The Baby Born To Mothers Over 45
At around 40, the risk of Down syndrome is one in 100, which increases to one in 10 by the age of 49. There is also an increased risk of other chromosomal abnormalities, stillbirth, and premature labor .
Due to this, many older women who want to get pregnant prefer donor eggs assuming the risk is low with younger eggs. Before you make a final decision, discuss about genetic testing with your healthcare practitioner.
However, there are ways in which you can ensure that a late pregnancy is a healthy pregnancy.
Can I Get Pregnant At 45
Redheadedlass over a year ago
I’m just turning 46 and getting married. I was married years ago and never thought that I would remarry, so gave up the dream of children because I was too afraid to do alone. I have been pregnant, once in my early 20s, but there were complications, never had it. Now I wish that I would have tried. Now I’m desperate to have a baby, everywhere I read, says it’s impossible at my age, even with IVF. I don’t know how we could afford IVF anyway, my insurance doesn’t cover it. Should I just give up, so depressed about it, probably going to ruin my wedding.
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kari1024253845 over a year ago
no dnt give up and second try to stay calm when a female get too tense its hard to get pregnant i had seen women in their 50 pregnant its all bt the right time stay calm do dutty alot but never feel to pressure about it have faith
Guest over a year ago
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Getting Pregnant In Your 30s
Women between the ages of 30 and 35 still have a reasonably high chance of getting pregnant. However, your fertility has already begun to decline by the time you turn 30. After the age of 30, your chances of pregnancy decline by about 3% each year.
Most significantly, your fertility drops sharply after the age of 35. At age 37, you can expect to have just 25,000 eggs 2.5% of your starting count. The risks of getting pregnant are also higher after age 35. By age 35, you are more likely to experience miscarriage, pregnancy complications, and genetic abnormalities of the fetus. For more information on getting pregnant in your 30s, check out our blog post here.
How These Pregnancies Happen
Getting pregnant without intervention, however, can be an issue. The chances of a women conceiving at 50 is not well studied. However, without any reproductive assistance, the chance of spontaneous conception is likely less than 1 percent, says Scott A. Shainker, DO at Beth Israel Deaconess Medical Center in Boston, MA. Not exactly betting odds.
Some scientists are hard at work to change all that. According to an article in New Scientist, a Greek fertility clinic is a trying to help menopausal women get pregnant using their own eggs by injecting their own platelet-rich plasma directly into their ovaries and uterus, with the goal of repairing their reproductive systems.
Until unconventional methods like this become conventional, Minkin says if a healthy woman in this age range wants to get pregnant but is unable to make eggs on her own, she could be a good candidate to have a donor egg fertilized with sperm in vitro, and have the embryo implanted into her uterus.
Rhonda Collins, the Oakland, CA-based co-founder and CEO of an online toy recycling community called Toy-cycle, had twins at the age of 48 via IVF using donor eggs from the Czech Republic. She says her doctor wasnt particularly alarmist about her pregnancy: My ob-gyn did not treat me differently. I live in a major urban center, so I think older moms are more common than perhaps smaller towns or rural areas, she recalls.
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What Are The Signs And Symptoms Of Pregnancy After 45
The symptoms would be similar to the ones women face in their younger age of pregnancy. But in most cases, they are taken to be the signs of menopause.
The signs and symptoms could be frequent urination, mood swings, headaches, breast changes, incontinence, fatigue, missed periods, nausea, and backaches.
As women over 45 will be at a higher risk of pregnancy complications.
Myths About Pregnancy In Your 40s:
1.Pregnancy is easy in your 40s and happens all the time. Once you hit 40, there is only a five percent chance you will get pregnant in any given month . Pregnancy is possible, but women need to know the most valuable and irreversible factor impacting success is time. This is largely due to a steady decline in egg quality that begins when a woman is in her early 30s and accelerates in her late 30s.
2.Fertility issues are always with the woman. For men and women in their 20s, there is an equal chance of experiencing infertility for either partner. For couples with a female partner in her late 30s or 40s, the chance of infertility due to egg quality rises dramatically.
3.Celebrity moms make it look easy. They are having kids at age 46! There is an endless stream of celebrity mothers who are having kids in their 40s. Halle Berry had her baby at 46, Kelly Preston at 47, and Geena Davis had twins at 48. While its statistically unlikely that some older celebrities are having children without any assistance, its important to not compare your experiences with others. Some celebrities are open about their experiences with infertility, but most are not.
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Its Probably A Donated Egg
Its exceptionally rare for patients to get pregnant naturally at 50 or over 45. They make history, said Dr. David Keefe, an obstetrician-gynecologist and fertility researcher at New York University.
In part thats because around age 50, many women are entering menopause, after which egg harvesting isnt possible.
And as eggs age they also accumulate more genetic glitches. The mechanism is not completely understood, but it may be because eggs have shorter telomeres, the protective caps on the ends of our chromosomes.
Once the eggs DNA has accumulated damage it cant repair, then its division as an embryo goes haywire, with chromosomes sticking together when they should come apart. The resulting embryo may end up with too many or too few chromosomes, said Dr. Kutluk Oktay, a fertility doctor and researcher at the New York Medical College. The majority of those end up in miscarriages.
So older would-be mothers often use eggs donated by younger, more fertile women. For younger women seeking pregnancy, donor eggs might only be discussed after theyve tried other kinds of fertility treatments, but for those over 45, thats kind of where they start, said Alicia Abdella, an infertility social worker at Massachusetts General Hospital.
Is 40 Too Old To Have A Baby
We live in a different world than our mothers and grandmothers. Many women today make the decision to focus on their careers, travel and get to a better place financially before they settle down and have children. In fact, according to a survey put together by online personal finance company SoFi and reproductive health company Modern Fertility, 60% of survey respondents said theyre waiting to have kids because of money, and 51% said they wanted to get to a higher salary bracket before growing a family becomes a consideration.
In terms of safety, technological advancements in health care related to fertility and pregnancy have made it increasingly possible to have a baby into your 40s. In the next question, we discuss fertility and give you a better understanding of the possibility of getting pregnant after 40.
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What Prenatal Tests Will You Need If Youre Pregnant At 45 Will There Be More Than Usual
Youll likely get poked and prodded more than your younger-mom counterparts, but you may find the additional testing and extra attention reassuring.
Youll be scheduled for routine prenatal testing, including NIPT for chromosomal conditions and the glucose test for gestational diabetes .
Youll also be closely monitored for high blood pressure and preeclampsia, which also crop up more often in older pregnancies. And you may have additional ultrasounds to monitor the babys growth, since low birth weight is another pregnancy complication that is more common in older expectant moms.
Because the rates of Down syndrome and other chromosomal conditions are greater in babies of older moms-to-be, youll likely be encouraged to undergo chorionic villus sampling between 10 and 13 weeks of pregnancy or amniocentesis, which is done between weeks 15 and 20 of pregnancy and most often between 16 and 18 weeks.
If you conceive with a donor egg or your own eggs that were previously frozen, the risk of chromosomal abnormalities in your baby would be based on the age of the donor or your age when your eggs were frozen. It’s a good idea to inform your doctor of those details so he or she can provide an accurate assessment of that risk.