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Fertility after 40.

A woman’s best reproductive years are in her 20s. Fertility gradually declines in the 30s, particularly after age 35. Yet, the number of women trying to get pregnant in their forties is rapidly rising. Whether due to personal choice or life circumstances, the reality is that it is harder to get pregnant as age increases. There are fewer eggs remaining in the ovaries and the quality of those eggs decline with time, leading to infertility.  By age 40, a woman’s chance of pregnancy is less than 5% per cycle. Even when pregnancy occurs, women at age 40 have a 50% chance of miscarriage. At age 45, the rate of miscarriage is greater than 80%, usually due to chromosomal abnormalities. 

So, how come celebrities have babies in their 40’s and 50’s? Many of them use assisted reproduction techniques like IVF to overcome infertility. Many also use donor eggs from younger women to increase their chances of getting pregnant. Does it mean IVF is the only option once a woman turns 40? Not at all. Normal, healthy pregnancies do occur after the age of 40. Here are a few things to improve your chances of success:

  1. Don’t delay seeking treatment. Infertility evaluation is recommended if a woman is 35 and has been trying for 6 months. 
  2. If there is an obvious medical problem like irregular periods, it’s okay to skip the 6 month wait and seek care for infertility immediately.
  3. Fertility evaluation includes ovarian testing, semen analysis, fallopian tube and uterine assessment. This can be done by a gynecologist.
  4. Some medical problems in the older patient can cause infertility or increase the pregnancy risk to mom. Women with chronic diseases such as high blood pressure or diabetes must have them under control before attempting pregnancy. Medications are especially important to reduce potential harm to the baby. 
  5. Routine testing for genetic diseases carrier is recommended prior to pregnancy.
  6. IVF techniques can help reduce the risk of chromosomal abnormalities.
  7. After conception, prenatal testing can be done to check for certain birth defects.   

As a woman’s age increases, so does infertility. Even with IVF, it is still harder to get pregnant as women get older. Seek infertility help early. Let’s start with a consultation with your gynecologist.

Dr. Chetanna Okasi Dr. Okasi is a board certified obstetrician/gynecologist, and the medical director of Women's Wellness MD. Her mission is to help women achieve total wellness of mind, body, and spirit.

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