Our guide will go over everything you need to know about getting pregnant at 40. Learn what the chances are and what to do to increase your odds of conception.
The term 'geriatric pregnancy' is outdated and has been thrown out the window. Instead, doctors consider women over 35 as at an advanced maternal age.
More and more women find motherhood in their 40s as medical technology and fertility treatments advance. Based on research, women in their 40s have a 20% chance of conceiving naturally or with IVF, while their counterparts in their 20s have a 45% chance.
Women over 40 generally only have a 5% chance of conceiving each menstrual cycle.
When women reach their 40s, they have less than 25,000 eggs left.
While healthy pregnancies are possible, it's important to be aware of the increased risks of complications, such as getting diabetes or having a miscarriage.
Many women in their 40s get pregnant and have healthy pregnancies. And conceiving at any stage in life is a personal decision between you and your doctor.
Let's look at the risks of having a baby as you advance in maternal age and how to increase the chances of getting pregnant after 40.
Many women ask themselves, is it harder to get pregnant at 40?
The simple answer is yes; getting pregnant over 40 is just more challenging than when you were in your 20s.
According to most fertility specialists, women over 40 only have about a 5% chance of conceiving each menstrual cycle.
The sudden decrease in fertility is due to a drop in how many eggs a woman produces.
So it makes sense that over the years, the supply would drop to 25,000 by the age of 37, and be nearly depleted by a woman’s 40s.
The eggs a woman has left are more likely to have chromosomal issues that can cause genetic disorders.
Another risk of getting pregnant at 40 is miscarriage. The risk of miscarriage rises to 53% in women 45 and older.
The same chromosomal issues that cause miscarriages can lead to an increased risk of extra or missing chromosomes in the embryo.
Additionally, the increase in abnormal chromosome numbers causes congenital defects, some of which don't present themselves until after birth. Here are some risks to consider as you consider getting pregnant in your 40s.
The placenta grows during your entire pregnancy and is how the body feeds a developing baby. A woman's cervix is the opening to the birth canal where the baby travels during delivery.
Placenta previa happens when the placenta grows at the bottommost part of the womb, which then covers the opening of the cervix.
In women under 40, the rate of placenta previa is 1 in 200—women of advanced maternal age experience placenta previa at a higher rate.
Most cases of placenta previa are found during a second-trimester ultrasound.
Fetal macrosomia is a medical condition where a fetus' weight is in the top 10% of your pregnancy stage.
The risks of carrying a too-big baby (more than 11 pounds) include vagina tears and problems pushing the baby out of the birth canal.
One study found a 20% increase in the odds of macrosomia in women who are over 40.
In most cases, your obstetrician will recommend a C-section as the safest option for fetal macrosomia.
Gestational hypertension is high blood pressure that presents itself at 20 weeks and stops shortly after the baby is born.
Pregnancy-related hypertension happens in about 6% to 8% of all pregnancies. As women age, the risk of high blood pressure increases. The risk of gestational hypertension is 1-63 times higher in mothers over 40 than in mothers between the age of 25 and 29.
Gestational hypertension may not always have symptoms, which is why it's vital to go to prenatal doctor visits so that they can take and monitor your blood pressure.
If your healthcare provider suspects high blood pressure, they will want to monitor you and the baby more closely to manage gestational hypertension.
Gestational diabetes is a type of diabetes that happens when sugar levels rise too high. Typically, GD is detected between 24 and 28 weeks and goes away once the baby is born.
The condition occurs in 2% to 10% of pregnancies in the US. Hormonal changes during pregnancy lead to changes in the way the body converts food to energy.
As women age, pregnancy-induced gestational diabetes happens at a higher rate. If detected, your obstetrician will want to track sugar levels closely until delivery.
A cesarean section or cesarean delivery (C-section) is a surgical procedure that involves an incision in your abdomen and uterus in order to deliver a baby.
Doctors often perform C-sections when vaginal delivery is dangerous or comes with health risks for the mother or baby.
Your obstetrician may plan a C-section if you have certain conditions that include:
Some conditions may lead to an unplanned C-section.
Women of advanced maternal age have C-sections at a higher rate (43%) than their younger peers (11.6%).
The difference between miscarriage and stillbirth is that stillbirth happens after the 20th week, while a miscarriage occurs before 20 weeks.
Women over 40 experience miscarriages or stillbirths more often than younger mothers.
In one study, women over 40 had a 40% to 50% higher risk of stillbirth than women 20 to 29.
Age is not the only factor for stillbirth.
Birth defects are more common than people believe. Congenital defects occur in about 1 in 33 babies born.
Older pregnant women are at a higher risk of delivering a baby with chromosomal birth defects, which can include:
Postpartum hemorrhage (PPH) is a dangerous condition that can happen after delivery. It consists of severe bleeding and occurs within 24 hours of delivery. But, PPH is possible for up to 12 weeks after childbirth.
Around 40% of cases of PPH happen to women with no risk factors or underlying conditions.
But, research does show that PPH happens to women as they advance in maternal age.
A hysterectomy is a surgical procedure that involves the removal of the uterus and, likely, the cervix.
Postpartum hysterectomies are often due to postpartum hemorrhage. According to one study, the risk of postpartum hysterectomy was higher in women older than 40.
Your numerical age is only one factor when trying to get pregnant after 40. The older we get, the more likely we are to have bad habits or underlying health conditions. There are ways to improve fertility in general to up the chances of getting pregnant at 40.
Science shows that the more frequently a couple engages in sexual intercourse during the most fertile window, the more likely they are to conceive.
You can find plenty of apps and over-the-counter (OTC) ovulation indicators to help track your menstrual cycle so you'll know when you're the most fertile.
Regardless of age or gender, a couple needs to lay off drinking and stop smoking when trying to conceive.
Consuming alcohol and cigarettes is not only counterproductive to getting pregnant, but it can also harm the pregnancy when it does happen.
A nutritional approach is a proven way to increase fertility in women. A diet of whole grains, vegetables, and fish is a great way to prepare for having a baby at 40.
Foods that are high in unsaturated fats, like avocado and sunflower seeds, boost fertility in women of all ages.
Some women find that changing their diet isn't enough to get the required nutrients. Fertility supplements, such as Fertility for Her, are available to fill in those nutritional gaps.
Research does not show that stress levels alone lead to infertility. But, anxiety and stress can prolong how long it takes to conceive.
Women undergoing IVF do see a decrease in successful fertilization when stress levels are high.
Meditation, yoga, and other mindfulness exercises are simple ways to try and rid yourself of stress.
You can help prevent ovulatory-factor infertility by just adding exercise to your daily routine. 30 minutes of physical activity is especially vital for women over 40 or struggling with obesity.
At the same time, too much exercise (60+ minutes) can up the risk factor for ovulatory-factor infertility.
Finding a balance in exercise can balance hormones, improve insulin, and reduce stress, which can all boost fertility.
Being underweight can affect fertility as much as obesity or a high BMI.
When women are underweight, the body stops producing estrogen. The low hormone levels can lead to irregular menstrual cycles, and you may even stop ovulating and getting a period at all.
Make sure to eat a well-rounded diet. A food diary can help you track your eating habits.
Your doctor or specialist may recommend you work with a dietitian to find the right path towards being at a healthy weight.
If you've wondered if 40 is too old to have a baby, pregnancy is possible, but it may come with some challenges.
For some women, the risks of getting pregnant at 40 can include placenta previa, macrosomia, gestational hypertension, and gestational diabetes.
Miscarriages and stillbirths in women of advanced maternal age are more common than in younger mothers.
Some risks of pregnancy after 40 are postpartum, such as postpartum hemorrhage, which can result in a hysterectomy.
Studies have shown that advanced maternal age and birth defects are associated, including cleft lip or palate, congenital inguinal hernia, and cardiac defects.
Regardless of age, what you eat, how often you exercise, and your lifestyle can affect fertility. You can naturally boost fertility by finding balance in your nutrition and exercise and by giving up drinking and smoking.
Have a one-on-one conversation with your physician or fertility doctor about getting pregnant at 40 and the risks it may include. Also, discuss any supplements, medications, or diet changes that can potentially help.
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Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe Frauenheilkd. 2015 Aug;75(8):827-832. doi: 10.1055/s-0035-1546109. PMID: 26366002; PMCID: PMC4554509. Accessed on Jul, 20, 2023.
"Age and Fertility - Better Health Channel." Betterhealth.vic.gov.au, 2021, www.betterhealth.vic.gov.au/health/conditionsandtreatments/age-and-fertility. Accessed on Jul, 20, 2023.
"Female Age-Related Fertility Decline - ACOG." Acog.org, 2022, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/03/female-age-related-fertility-decline. Accessed on Jul, 20, 2023.
Wagan N, Amanullah AT, Makhijani PB, Kumari R. Factors Associated With Gestational Diabetes Mellitus: A Cross-Sectional Study. Cureus. 2021 Aug 11;13(8):e17113. doi: 10.7759/cureus.17113. PMID: 34532166; PMCID: PMC8436834. Accessed on Jul, 20, 2023.
Wiles K, Damodaram M, Frise C. Severe hypertension in pregnancy. Clin Med (Lond). 2021 Sep;21(5):e451-e456. doi: 10.7861/clinmed.2021-0508. PMID: 34507929; PMCID: PMC8439512. Accessed on Jul, 20, 2023.
Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019 Mar 20;364:l869. doi: 10.1136/bmj.l869. PMID: 30894356; PMCID: PMC6425455. Accessed on Jul, 20, 2023.
Genetic Alliance; The New York-Mid-Atlantic Consortium for Genetic and Newborn Screening Services. Understanding Genetics: A New York, Mid-Atlantic Guide for Patients and Health Professionals. Washington (DC): Genetic Alliance; 2009 Jul 8. APPENDIX F, CHROMOSOMAL ABNORMALITIES. Available from: https://www.ncbi.nlm.nih.gov/books/NBK115545/. Accessed on Jul, 20, 2023.
Anderson-Bagga FM, Sze A. Placenta Previa. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539818/. Accessed on Jul, 20, 2023.
Marozio L, Picardo E, Filippini C, Mainolfi E, Berchialla P, Cavallo F, Tancredi A, Benedetto C. Maternal age over 40 years and pregnancy outcome: a hospital-based survey. J Matern Fetal Neonatal Med. 2019 May;32(10):1602-1608. doi: 10.1080/14767058.2017.1410793. Epub 2017 Dec 7. PMID: 29216770. Accessed on Jul, 20, 2023.
Mohammadbeigi A, Farhadifar F, Soufi Zadeh N, Mohammadsalehi N, Rezaiee M, Aghaei M. Fetal macrosomia: risk factors, maternal, and perinatal outcome. Ann Med Health Sci Res. 2013 Oct;3(4):546-50. doi: 10.4103/2141-9248.122098. PMID: 24380006; PMCID: PMC3868121. Accessed on Jul, 20, 2023.
Usta A, Usta CS, Yildiz A, Ozcaglayan R, Dalkiran ES, Savkli A, Taskiran M. Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus. Pan Afr Med J. 2017 Feb 2;26:62. doi: 10.11604/pamj.2017.26.62.11440. PMID: 28451039; PMCID: PMC5398855. Accessed on Jul, 20, 2023.
"High Blood Pressure During Pregnancy - CDC." Cdc.gov, 2023, www.cdc.gov/bloodpressure/pregnancy.htm. Accessed on Jul, 20, 2023.
Quintanilla Rodriguez BS, Mahdy H. Gestational Diabetes. [Updated 2022 Sep 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545196/. Accessed on Jul, 20, 2023.
Bouzaglou A, Aubenas I, Abbou H, Rouanet S, Carbonnel M, Pirtea P, Ayoubi JMB. Pregnancy at 40 years Old and Above: Obstetrical, Fetal, and Neonatal Outcomes. Is Age an Independent Risk Factor for Those Complications? Front Med (Lausanne). 2020 May 27;7:208. doi: 10.3389/fmed.2020.00208. PMID: 32537454; PMCID: PMC7266997. Accessed on Jul, 20, 2023.
"Cesarean Section - John Hopkins Medicine." Hopkinsmedicine.org, 2023, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cesarean-section. Accessed on Jul, 20, 2023.
Ecker JL, Chen KT, Cohen AP, Riley LE, Lieberman ES. Increased risk of cesarean delivery with advancing maternal age: indications and associated factors in nulliparous women. Am J Obstet Gynecol. 2001 Oct;185(4):883-7. doi: 10.1067/mob.2001.117364. PMID: 11641671. Accessed on Jul, 20, 2023.
Maslovich MM, Burke LM. Intrauterine Fetal Demise. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557533/. Accessed on Jul, 20, 2023.
Dongarwar D, Aggarwal A, Barning K, Salihu HM. Stillbirths among Advanced Maternal Age Women in the United States: 2003-2017. Int J MCH AIDS. 2020;9(1):153-156. doi: 10.21106/ijma.346. Epub 2020 Feb 10. PMID: 32123639; PMCID: PMC7031887. Accessed on Jul, 20, 2023.
"Birth Defects are Common, Costly, and Critical - CDC." Cdc.gov, 2023, www.cdc.gov/ncbddd/birthdefects/infographic.html. Accessed on Jul, 20, 2023.
Gill SK, Broussard C, Devine O, Green RF, Rasmussen SA, Reefhuis J; National Birth Defects Prevention Study. Association between maternal age and birth defects of unknown etiology: United States, 1997-2007. Birth Defects Res A Clin Mol Teratol. 2012 Dec;94(12):1010-8. doi: 10.1002/bdra.23049. Epub 2012 Jul 23. PMID: 22821755; PMCID: PMC4532312. Accessed on Jul, 20, 2023.
Hofer S, Blaha J, Collins PW, Ducloy-Bouthors AS, Guasch E, Labate F, Lança F, Nyfløt LT, Steiner K, Van de Velde M. Haemostatic support in postpartum haemorrhage: A review of the literature and expert opinion. Eur J Anaesthesiol. 2023 Jan 1;40(1):29-38. doi: 10.1097/EJA.0000000000001744. Epub 2022 Sep 22. PMID: 36131564; PMCID: PMC9794135. Accessed on Jul, 20, 2023.
Pettersen S, Falk RS, Vangen S, Nyfløt LT. Exploring trends of severe postpartum haemorrhage: a hospital-based study. BMC Pregnancy Childbirth. 2023 May 19;23(1):363. doi: 10.1186/s12884-023-05702-6. PMID: 37208647; PMCID: PMC10197212. Accessed on Jul, 20, 2023.
Huque S, Roberts I, Fawole B, Chaudhri R, Arulkumaran S, Shakur-Still H. Risk factors for peripartum hysterectomy among women with postpartum haemorrhage: analysis of data from the WOMAN trial. BMC Pregnancy Childbirth. 2018 May 29;18(1):186. doi: 10.1186/s12884-018-1829-7. PMID: 29843627; PMCID: PMC5975404. Accessed on Jul, 20, 2023.
Konishi S, Saotome TT, Shimizu K, Oba MS, O'Connor KA. Coital Frequency and the Probability of Pregnancy in Couples Trying to Conceive Their First Child: A Prospective Cohort Study in Japan. Int J Environ Res Public Health. 2020 Jul 10;17(14):4985. doi: 10.3390/ijerph17144985. PMID: 32664373; PMCID: PMC7399901. Accessed on Jul, 20, 2023.
de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, Di Dato C, Sirico F, Alviggi C, Isidori A, Colao A, Pivonello R. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol. 2020 Mar 12;18(1):21. doi: 10.1186/s12958-020-0567-7. PMID: 32164734; PMCID: PMC7069005. Accessed on Jul, 20, 2023.
Panth N, Gavarkovs A, Tamez M, Mattei J. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Front Public Health. 2018 Jul 31;6:211. doi: 10.3389/fpubh.2018.00211. PMID: 30109221; PMCID: PMC6079277. Accessed on Jul, 20, 2023.
Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci. 2018 Mar;20(1):41-47. doi: 10.31887/DCNS.2018.20.1/klrooney. PMID: 29946210; PMCID: PMC6016043. Accessed on Jul, 20, 2023.
Aimagambetova G, Issanov A, Terzic S, Bapayeva G, Ukybassova T, Baikoshkarova S, Aldiyarova A, Shauyen F, Terzic M. The effect of psychological distress on IVF outcomes: Reality or speculations? PLoS One. 2020 Dec 14;15(12):e0242024. doi: 10.1371/journal.pone.0242024. PMID: 33315878; PMCID: PMC7735622. Accessed on Jul, 20, 2023.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007 Nov;110(5):1050-8. doi: 10.1097/01.AOG.0000287293.25465.e1. PMID: 17978119. Accessed on Jul, 20, 2023.
Tang S, Huang J, Lin J, Kuang Y. Adverse effects of pre-pregnancy maternal underweight on pregnancy and perinatal outcomes in a freeze-all policy. BMC Pregnancy Childbirth. 2021 Jan 7;21(1):32. doi: 10.1186/s12884-020-03509-3. PMID: 33413207; PMCID: PMC7791874. Accessed on Jul, 20, 2023.