In this article
- What are my chances of getting pregnant naturally in my 40s?
- What are my chances of getting pregnant with fertility treatment?
- What are the pros and cons of having a baby in my 40s?
- How should I prepare for pregnancy?
- Should I see my doctor before trying for a baby?
- What should we do if we suspect a fertility problem?
Perhaps you’ve put off pregnancy to concentrate on your career, or because it’s taken you a while to find the right partner (Utting and Bewley 2011). Or perhaps you’ve been trying for a baby for a while, and your 40th has come and gone. The burning question for you now is, "Have I left it too late?"
The answer is no! Many 40-plus women do conceive, although there’s no denying that your odds of getting pregnant are lower than just a few years ago.
What are my chances of getting pregnant naturally in my 40s?
It depends how far into your 40s you are. At 40, your chance of conceiving is just over 20 per cent (based on the average annual rate of pregnancy per cycle), falling to about 10 per cent by your mid-40s. This compares to 35 per cent for women in their 30s, and 45 per cent for women still in their 20s (NICE 2013).
After 45, you’re less than five per cent likely to fall pregnant naturally (NICE 2013, Utting and Bewley 2011). As early as 15 years before you go through menopause, your number of eggs begins to decline.
Your reduced fertility is not just about the number of eggs you have, though. It’s also about their quality (RCOG 2011). By your 40s, the eggs that your ovaries release each month are more likely to have structural problems (chromosomal abnormalities).
Chromosomal abnormalities in your eggs can raise the risk of miscarriage and birth defects. This is why both these complications are more common in older women (NHS 2018a, RCOG 2011, RCOG 2016).
What are my chances of getting pregnant with fertility treatment?
There’s never been a better time to try to get pregnant as an older mum, given the range of fertility treatments available. Treatments such as intrauterine insemination (IUI) and IVF are being refined all the time.
In your early 40s you have about a one in seven chance of a live birth per treatment cycle (HFEA 2016 ). At age 43, success rates fall to around one in 10 or lower (HFEA 2016). From 44 onwards, your chances of success using your own eggs really are minimal, because conception rates per cycle of IVF are so low.
You may wish to explore the idea of IVF using donor eggs or embryos to try to conceive, as it will increase your chances of having a baby (Utting and Bewley 2011). The risk of miscarriage and chromosomal problems is consistent with the age of your egg donor, who will be in her 20s or 30s.
If you're aged 40 to 42, IVF may be available to you on the NHS. But this can vary depending on where you live, so you may have to pay for private treatment (NHS 2018b).
What are the pros and cons of having a baby in my 40s?
Pros
The greatest advantage of waiting to have children in your 40s is that you are probably more emotionally and financially ready for them. You’ve had time to see the world, and you’re more likely to be secure financially and comfortable in your career.
If you’ve been with your partner for a while, you will have had the chance to get to know each other in all sorts of circumstances. This will provide a solid foundation for raising a family.
As an older mum, you’ll be in a good position to make wise parenting decisions. Your life experience means you’ll feel pretty confident about your approach to child-bearing (Hansen et al 2010). You may have a sense that you’ve been there, done that. You’ll be less concerned with your own needs, and will be happy instead to focus on your child.
You’re also more likely to breastfeed (McAndrew et al 2012), which is good for your health as well as your baby’s.
Your income is likely to be higher, as you will have had time to establish yourself in your career. You’ll probably go back to work more quickly, and at a higher level of pay than younger women. That’s the case even if you go back to work part-time (TUC 2016, Utting and Bewley 2011).
Being financially secure has its benefits. It’s estimated to cost about £150,753 for a couple to raise a child until they're 18. That's £8,375 a year on average (Hirsch 2018).
For single parents, raising a child until they reach 18 costs even more money due in part to the high cost of childcare. It's estimated to cost £183,335, which is £10,185 a year on average (Hirsch 2018).
Cons
If you do conceive, you are more likely to need extra care during your pregnancy. So the cons below are to do with health rather than lifestyle.
Most older mums have healthy pregnancies and babies but you do have an increased risk of ongoing health problems, such as diabetes and high blood pressure (NHS 2016). These conditions can affect how well your pregnancy and birth goes, as well as your health (Fretts 2018).
Sadly, miscarriage is more common in older women (Fretts 2018, RCOG 2011). The rate of miscarriage increases steadily, so that by the age of 45, you have about a one-in-two risk of miscarrying if you conceived naturally with your own eggs, rather than donor eggs (Fretts 2018, RCOG 2011).
Some pregnancy complications such as gestational diabetes (RCOG 2011) and pre-eclampsia (RCOG 2011, Utting and Bewley 2011) are also more common in older women.
Find out more about how your age can affect your pregnancy, baby and birth.
How should I prepare for pregnancy?
Age aside, there are steps you can take to give yourself the best chance for a normal pregnancy and a healthy baby.
You can make changes to your lifestyle to help your fertility. If you smoke, now’s the time to stop. Doctors also advise not to drink any alcohol at all while trying to conceive. Staying fit and keeping a healthy weight are also advisable (DH 2016, Utting and Bewley 2011).
Read our tips to help you prepare for pregnancy.
As soon as you decide to try for a baby, start taking a daily supplement containing 400 micrograms (mcg) of folic acid (NHS 2017). Taking folic acid has been found to greatly reduce the risk of neural tube defects, such as spina bifida.
Should I see my doctor before trying for a baby?
Yes, it's a good idea. Most GP surgeries in the UK provide preconception care, which is care before you become pregnant. This may be provided by a GP, a midwife or a practice nurse (NHS 2018).
Your GP will advise you about lifestyle choices that could affect your chances of getting pregnant and your developing baby. Another benefit of having a check-up is that you can get up-to-date with health checks and vaccinations.
What should we do if we suspect a fertility problem?
Some medical problems can make it harder to conceive. It's important to see your GP if you have or have had:
- irregular or no periods (NICE 2013)
- fibroids (CKS 2017)
- endometriosis (CKS 2014)
- polycystic ovary syndrome (PCOS) (NICE 2013)
- sexually transmitted diseases (Utting and Bewley 2011)
- pelvic inflammatory disease (Utting and Bewley 2011)
- cervical surgery (Utting and Bewley 2011)
You and your partner should also see your doctor straight away if your partner has a known fertility problem.
If you do have problems conceiving, you're likely to be referred to a fertility specialist sooner rather than later. Most specialists start with blood tests and investigations to check your fallopian tubes or your partner’s sperm.
Discover how to get a fertility test, find out the best time to have baby-making sex, or read these tips on getting your life ready for having a baby.
References
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