However, if you want to understand why getting pregnant after 35 is more difficult, learn about the various pregnancy risks after 35, and find out what your real odds are for pregnancy success—keep reading!
Fertility and Age
You’ve no doubt seen the myriad of features focusing on women waiting until after age 35 to have children and having trouble getting pregnant. The first thing to know is that women (and men) of all ages can experience infertility. Couples in their 20s can be just as infertile as couples in their early 40s. Age is only one aspect of fertility. Let’s assume, however, that a woman’s fertility is fine. That the only thing to be concerned about is her age. Fertility peaks in most women in the 20s. A gradual but significant decline begins around age 32. Yes, your odds of conception at 33 are not as good as they were at 28. At around age 37, fertility starts to decline at a much more rapid pace. Also, many studies struggle to distinguish whether pregnancy odds go down due to fertility or due to couples having less frequent sex. One study of 782 couples looked at the odds of conceiving based on the day of sexual intercourse before ovulation. The women used basal body temperature charting to track ovulation and found:
For both younger and slightly older women, two days before ovulation was their most fertile day. For women age 19 to 26, sex on their most fertile had a 50% chance of leading to pregnancy. For women age 35 to 39, the odds were 29%.
Male Fertility and Age
While we’re discussing the effect of female age, it’s important to mention that your partner’s age matters as well. Male fertility doesn’t decline the same way female fertility declines, but male age does matter. Remember the study mentioned above, the one that found women age 35 to 39 had a 29% chance of conceiving on their most fertile day? That same study found that if a woman’s partner was five years older, their odds dropped to 15%. Essentially, their odds halved. Keep in mind that these are the odds of conception. Just because you get pregnant doesn’t mean you’ll give birth. Miscarriage rates are higher for older mothers and fathers.
Increased Risks
Age also increases the chances of genetic problems. This is the reason for the increased risk of Down syndrome babies in women over age 35:
At age 25, 1 in 1,250 women will give birth to a child with Down syndrome.At age 30, it’s a 1 in 952 risk.By age 35, the chance is 1 in 378.
Your risk for miscarriage also rises with age:
About 10% of pregnancies end in miscarriage for women in their early 20s.By the early 30s, 12% of women experience miscarriages.After age 35, 18% of pregnancies will end in miscarriage.In the early 40s, 34% of pregnancies end in miscarriage.
Why Fertility Declines
Women are born with all the eggs they will ever have. The highest number of oocytes (or eggs) occurs when a baby girl is still in utero. At about 20 weeks gestation, a girl fetus has six to seven million eggs in her ovaries. At birth, she will be born with just over a million eggs. By puberty, between 300,000 to 500,000 are left. From this huge number of eggs, only 300 will ever become mature and be released in the process known as ovulation. Some people think menopause is the start of the fertility decline. This isn’t so. Our bodies’ reproductive capabilities slow down much earlier. As women age, the ovaries become less effective at producing mature, healthy eggs. What if you live a healthy lifestyle? What if you exercise, eat right, maintain a healthy weight, and avoid bad health habits? Even then, you will experience the natural fertility decline with age. With that said, bad health habits can have a negative effect on fertility. For example, smoking has been found to speed up the natural fertility aging process in women.
Success Rates After Age 35
Maybe you’re thinking you can just use fertility treatments. With IVF available, why worry about age? Unfortunately, it doesn’t work that way. Just as your body doesn’t respond as well to your own hormones (the ones responsible for ovulation), your body will also not respond as well to fertility drug hormones. The good news is that while the ovaries don’t work as well as women age, the uterus doesn’t seem to suffer as dramatically from aging. Women who can’t conceive using their own eggs can turn to egg donor IVF.
41.5% for women younger than 3531.9% for women age 35 to 3722.1% for women age 38 to 4012.4% in women age 41 to 425% for women ages 43 to 441% for women older than 44 years old
Women who used fresh (not frozen) egg donor IVF had an average 56% chance of pregnancy across all age groups, with odds reducing by age. While 36% of IVF implantations using a woman’s own fertilized eggs resulted in pregnancy.
Impact of Supplements
If you’ve been looking for information on getting pregnant after 35, or especially after 40, you’ve no doubt come across supplements and “natural remedies” promising to “reverse” ovarian aging. The truth is there are currently no proven supplements or fertility treatments that can reverse or “undo” ovarian aging. Most of these products being sold have either no research behind them, only weak studies to back them up, or are simply old wives tales. There are a number of websites looking to scam men and women desperate to have a baby. DHEA supplementation may improve IVF success in women of advanced reproductive age. A 2018 meta-analysis of several studies found DHEA supplementation increased the likelihood of pregnancy and reduced the risk of miscarriage. However, DHEA supplementation can cause hormonal imbalance. It should not be taken without the guidance of a reproductive endocrinologist. One fertility supplement that every woman should be taking, regardless of age, is folate, or folic acid. While you should always talk to your doctor before taking any fertility supplement, getting enough folate is essential to avoid certain birth defects and may play a role in preventing pregnancy loss.
When to See Your Doctor
Assuming you don’t have any symptoms or risk factors of infertility, you can start off trying to get pregnant the natural way. Be sure you’re educated about getting pregnant after 35. However, if you aren’t pregnant after six months, see your doctor. The reason you can’t get pregnant may or may not have to do with your age. However, because as you get older, your odds for pregnancy success even with fertility treatment will decrease, it’s important to get help quickly. If you are age 40 and wanting to get pregnant, see your doctor right away. You don’t need to start trying on your own first. You can ask for basic fertility testing. Specifically, you want them to test your AMH and FSH levels. This will give your doctor an idea of your current ovarian reserves. Whatever you do, don’t waste your time or money on at-home FSH or “menopause” tests. They may reassure you that your fertility is fine when it really isn’t.
