Baby fever? It can strike at any age. If you’ve waited until a bit later in life to try to conceive, you may wonder if you’re too old to have a baby.
A pregnancy after age 35 automatically puts you in the “advanced maternal age” (AMA) category. But try your best to not let that label intimidate you — successful pregnancy after 35 is still common! But what about after 40? 45?
While the road to getting pregnant may be harder for some after a certain age, others may sail through relatively easily. There are many factors at play, including things like your current health status and how close you are to menopause.
Here’s more about your chances of conceiving by age, what risks may be involved for you and your baby, and what questions you may want to ask your doctor before you embark on this journey.
It’s true that there’s a biological clock of sorts. It starts when you get your first period and stops when you reach menopause. As time goes on, your chances of having a successful pregnancy become less and less as your egg reserve diminishes, your egg quality decreases, and your hormones change.
Fertility rates trend with the average number of eggs a woman has at any given age. In general, you begin puberty with between 300,000 to 500,000 eggs. This number drops to around 25,000 at age 37 and continues dropping to 1,000 or fewer by age 51.
How does this look exactly? Well, the likelihood of becoming pregnant naturally (without medical assistance) after a year of trying is as follows:
|<30 years old||85 percent|
|30 years old||75 percent|
|35 years old||66 percent|
|40 years old||44 percent|
Even if you have a lot of eggs and you’re in your 20s or early 30s, your chance of getting pregnant in any given month is 1 out of 4, according to ACOG. By the time you reach 40, only 1 in 10 women will get pregnant each cycle.
Regarding women who undergo artificial reproductive technology (ART), live birth success rates follow a similar decreasing trend with age, according to
|Younger than 35 years old||31 percent|
|35 to 37 years old||24 percent|
|38 to 40 years old||16 percent|
|41 to 42 years old||8 percent|
|43 years old and older||3 percent|
Related: A look at your fertility timeline
Menopause is defined as the stopping of the menstrual cycle (for a year or longer). Most women reach this milestone somewhere between their late 40s and early 50s, with an average age of around 51 years old. So, it’s entirely possible to get pregnant the old-fashioned way into your 50s.
Easy? Not necessarily. But possible? Yes.
Before the menstrual cycle completely stops, there’s a period called perimenopause when cycles become longer and less regular.
Generally, women enter perimenopause sometime in their mid 40s, but some may hit this point as early as their mid 30s. You’re still producing eggs during this time, so pregnancy is possible — albeit more difficult to achieve.
Of course, you’ve probably heard stories of much older women carrying pregnancies to term. For example, a 74-year-old woman in India gave birth to twin girls in 2019.
What’s important to understand about stories like these is that these women often undergo hormone therapy and in vitro fertilization (IVF). They’re the rare exception, not the norm.
The majority of women over age 45 can’t conceive without the help of IVF and other ART procedures. That said, the American Society of Reproductive Medicine (ASRM) shares that any woman of any age can get pregnant — with medical help — provided that she has a “normal uterus” even if she no longer has ovaries or ovarian function.
Many women are able to carry pregnancies after age 35 and beyond. However, there are certain risks — for both mother and baby — that tend to increase with maternal age.
- Infertility. It may take longer to get pregnant as you get closer to menopause. Why? Your body begins life with a set number of eggs. As time goes on, that number becomes fewer and fewer. Eggs may also be of lesser quality as you age, meaning they may be harder to fertilize/implant.
- Miscarriage. With a decrease in egg quality comes a higher risk of miscarriage. Pregnancy loss may also be more likely due to medical conditions you have, like high blood pressure or diabetes. Stillbirth is another possibility as well, so it’s important to keep up with prenatal appointments to catch issues early.
- Chromosome issues. Older women may also encounter more chromosome issues. For example, the risk of having a child with Down syndrome is around 1 in 1,480 for women at age 20. At age 40, this risk increases to 1 in 85.
- Multiples. While having more than one bundle of joy may sound more like a blessing than anything else, carrying multiples comes with additional risks. The reasons twins or higher order multiples are more likely over age 35 has to do with hormonal changes (you may release more than one egg each cycle) and the use of ART like IVF.
- Gestational diabetes. Diabetes that develops during pregnancy may make a baby grow large while still inside the womb. When a baby is too large, there’s a possibility of injury at birth. Not only that, but gestational diabetes can contribute to high blood pressure (for mom) and premature birth or other complications (for baby).
- High blood pressure. Developing gestational hypertension or preeclampsia during pregnancy is also more likely over age
- Low birth weight. Different maternal complications may lead to your baby being born prematurely and at a low birth weight, which is associated with additional complications.
- Cesarean delivery. With pregnancy complications comes an increased risk of having a C-section versus vaginal delivery. In fact,
cesarean delivery rates increasethe older you get: from 26 percent at age 20 to 40 percent at age 35 to 48 percent at age 40.
Even with the risks, some 17 percent of pregnancies in the United States are to mothers who are over 35. So, if you’d 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 (diet, exercise, etc.) 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 (if any)?
- What ART procedures might you recommend if we’re 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 (number of eggs you have). 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.
Related: 9 questions about infertility treatments to ask your doctor
If you feel you’ve started this journey too late, have a frank discussion with your doctor. Make a preconception visit. Understand your odds and the risks associated with pregnancy at whatever age you find yourself.
Regardless, your age doesn’t mean you can’t explore other ways to grow your family. Other options include:
- IVF with donor eggs. With this process, you prime your body for pregnancy using hormones. Instead of doing a traditional egg retrieval to later fertilize and transfer, you do an embryo transfer using embryos created with donor eggs that are fertilized with either your partner’s sperm or donor sperm.
- Surrogacy. You may also choose to use a surrogate mother to have your baby. This process involves choosing a surrogate, deciding how pregnancy will be achieved (IVF using a donor egg, your egg, your partner’s sperm, donor sperm, etc.), and then following the legal processes to gain full custody after birth.
- Egg freezing. If you know in advance that you’d like to wait to have a baby and you’re still under age 35, you might consider freezing your eggs now. If you freeze your eggs in your early 30s and plan to use them in your 40s, your odds of having a healthy baby relate to your age when you froze your eggs and not your current biological age.
- Embryo adoption. Whether you choose to do IVF yourself or to use a surrogate, embryo adoption is another option. Embryos are generally frozen and donated by couples who aren’t using them in their own ART procedures.
- Adoption. There are also many children who are seeking homes through the foster care system, private domestic adoption, or international adoption. Children range in ages from newborn all the way up to the teen years.
Related: I didn’t think surrogacy was for me. And then life happened.
If you’re over age 35 and have been trying to conceive for 6 months or longer, contact your doctor. While the rule you may have heard says you should try for a year before seeking help, this timeline becomes expedited as age increases.
If you’re currently dealing with physical or mental health issues, make a plan with your doctor to address those issues so you can get in the best shape to carry a pregnancy. This includes reaching a healthy weight through diet and regular exercise and kicking any unhealthy habits with drugs, alcohol, and smoking.
And once you do get pregnant, be sure to attend all your prenatal appointments so you can catch any issues that arise before they become bigger problems for your health or your baby’s health.
Being AMA means you may have additional appointments, tests, and ultrasounds. It may seem like a lot of office visits, but it’s all meant to keep you and your baby safe.
While age does matter when it comes to fertility, it isn’t a black and white issue. Understand the risks, but also understand that each woman and couple is unique. Infertility and pregnancy complications can strike at any age.
On the flip side, it’s possible to have a healthy pregnancy and delivery even at a more advanced age. And even if you feel you’ve waited too long, there are a variety of other options you can explore if you’re looking to grow your family.