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Pregnancy After 40. Is 35 The Pivot Point?

It’s quite common for women to consider having a baby after 35. Yet the downside of delaying pregnancy is declining ovarian reserve, which makes it harder to get pregnant and increases the risks, especially for miscarriage and chromosome abnormalities. Pregnancy after 40 increases the challenges.

While women are physically capable of carrying a child into their 40s, their chances of a healthy pregnancy decrease around age 35 with a much faster decline after 40. Time is of the essence when it comes to obtaining a diagnosis and pursuing fertility treatment.

Egg Quality Determines Outcomes

Ovarian reserve decreases with age

Ovarian reserve decreases with age

A common cause of infertility for women over 35 is diminished ovarian reserve (DOR). This condition is characterized by a low number of eggs in a woman’s ovaries and a greater likelihood that the remaining eggs will have chromosomal abnormalities that increase the risk for miscarriage and birth defects.

Ovarian reserve declines with age. On average, women have more healthy eggs at age 30 than they do at age 40; however, decline in egg reserve can happen quite quickly in any given individual.

The Decline Can Happen Very Quickly

Stacy B., a patient currently considering egg freezing for fertility preservation, was shocked to learn that her AMH, a hormone commonly used as a measure of ovarian reserve, was reduced by 50% over a period of two years.

“When I asked my nurse how this could happen, she told me that reproductive endocrinologists usually see a precipitous drop in AMH at some point in time – it’s not all perfectly gradual on an individual level, the way it looks on the graph. She said this drop usually happens around age 35, but occurs earlier than that for many women. This was very disappointing news.”

What Are the Risks?

Complications in pregnancy are another concern as women age. After age 35, there is an increased likelihood of high blood pressure, diabetes, placental problems, low birth weight and preterm delivery, multiple births and still births.

The Importance of a Fertility Assessment

A fertility assessment is needed to evaluate the potential for a healthy pregnancy. And, if there is a diagnosis of diminished ovarian reserve, it needs to be made swiftly so effective treatment can quickly follow. The chances of a woman using her own eggs to achieve pregnancy are greater the earlier there is an assessment of her ovarian reserve.

Elective Egg Freezing should be a consideration for women who want to preserve their best chances of a health pregnancy but are not yet ready for children. This process enables more “youthful eggs” to be “frozen in time” and used in the future. Pregnancy after 40 with your own frozen eggs may be the best of both worlds.

Data Supports Rapid Assessment

A recent study in the medical journal Fertility and Sterility found that 40-year-old women treated for infertility had a 25% chance of achieving pregnancy using their own eggs. By age 43 that number dropped to 10%, and by 44 it had to 1.6%. Among women who did get pregnant, the miscarriage rate was 24% for 40-year-olds, 38% for 43-year-olds, and 54% for 44-year-olds.

Chromosomal Anomalies Increase With Increasing Maternal Age

The risk of chromosomal abnormalities also increases as women age with Down’s syndrome being the most common outcome. EmbryoSelect™ Aneuploidy Screening is available for genetic testing to identify chromosomal abnormalities of this type.

Specializing in Advanced Maternal Age

At IVF New England, we specialize in helping women over 35 become pregnant with their own egg or with donor egg, if appropriate, using a treatment plan that best suits their individual needs.

Using donor egg boosts the odds of getting pregnant considerably, and, that’s how most of the older celebrity moms are doing it — whether they admit it or not. In vitro fertilization is an important option for older women with very good success rates.  For women in their 40s who elect eggs donated by women in their 20s or early 30s, the chance of a healthy baby is consistent with the age of the egg donor.

Given the range of assisted reproductive technology treatment options (ART) available to protect fertility and help older women try to get pregnant, now is the time to be proactive and take control of your fertility potential. Pregnancy after 40 can be what you want it to be if you plan ahead.

Request a consultation today. Call 800-858-4832.

Age impacts fertility, Causes of infertility in women, Genetic testing, Infertility, Miscarriage, Ovarian reserve