Why Getting Pregnant After 35 Is Harder and What You Can Do

What Your Real Odds of Conception Are and What to Do if You Can't Conceive

Woman in her 40s walking on beach with a child, getting pregnant after 35 is harder but not impossible
Even healthy, active women will experience fertility decline after 35. M Swiet Productions / Getty Images

Getting pregnant after 35 may be more difficult than at age 25... but it's not impossible. You can likely think of at least a few friends who conceived after 35, or even after 40.

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 to 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.

For example, some research has found that in any given month your chances of getting pregnant at age 30 are about 20 percent. Compare that to your odds at age 40: just 5 percent.

Don't confuse this with your odds of getting pregnant overall. This is a per month statistic, not per year.

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.

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 percent chance of leading to pregnancy.

For women age 35 to 39, the odds were 29 percent.

An Important Caveat on 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 percent 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 percent.

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 Risk of Birth Defects and Miscarriage

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 percent of pregnancies end in miscarriage for women in their early 20s.

By the early 30s, 12 percent of women experience miscarriages.

After age 35, 18 percent of pregnancies will end in miscarriage.

And, in the early 40s, 34 percent 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. The ovaries become less effective at producing mature, healthy eggs.

As you age and come closer to menopause, your ovaries will also respond less well to the hormones responsible for triggering ovulation. This includes fertility drugs, and is why fertility treatment is less successful in women with low ovarian reserves.

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.

Fertility Treatment 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.

According to statistics collected by the Center for Disease Control, the percentage of live births from IVF procedures using the mother's eggs decreases with age.

The live birth rates, after IVF treatment, are...

  • 41.5 percent for women younger than 35
  • 31.9 percent for women age 35 to 37
  • 22.1 percent for women age 38 to 40
  • 12.4 percent in women age 41 to 42
  • 5 percent for women ages 43 to 44
  • 1 percent for women older than 44 years old

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.

Regardless of age, women who used egg donor IVF had a 51 percent chance of pregnancy. Those odds are better than the younger women using IVF with their own eggs.

Are There Supplements to Reverse Ovarian Aging?

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. However, while a few small studies found success rate improvements, others have found no benefits. Plus, DHEA supplementation can cause hormonal imbalance. It should not be taken without the guidance of a reproductive endocrinologist.

Coenzyme Q10, or CoQ10, is has been found to improve egg quality in aging mice. But there’s no research showing this in humans yet.

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 avoiding certain birth defects and may play a role in preventing pregnancy loss.

What Should You Do if You Can't Conceive After 35?

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.

Women younger than 35 years old are usually told to try for a year before seeking help, but a year is too long to wait past age 35.

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.

Source:

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. "Female age-related fertility decline. Committee Opinion No. 589." Fertil Steril. 2014 Mar;101(3):633-4. doi: 10.1016/j.fertnstert.2013.12.032.

Dunson DB, Colombo B, Baird DD. "Changes with age in the level and duration of fertility in the menstrual cycle." Hum Reprod. 2002 May;17(5):1399-403.

Meldrum DR1, Casper RF2, Diez-Juan A3, Simon C4, Domar AD5, Frydman R6. “Aging and the environment affect gamete and embryo potential: can we intervene?” Fertil Steril. 2016 Mar;105(3):548-559. doi: 10.1016/j.fertnstert.2016.01.013. Epub 2016 Jan 23.

Narkwichean A1, Maalouf W2, Baumgarten M2, Polanski L2, Raine-Fenning N3, Campbell B2, Jayaprakasan K4. “Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial.” Eur J Obstet Gynecol Reprod Biol. 2017 Nov;218:39-48. doi: 10.1016/j.ejogrb.2017.09.006. Epub 2017 Sep 8.

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