About 1 in 10 women will conceive naturally after 40, while many other women in their 40s get pregnant with the help of assisted reproductive technology (ART). Like at every stage of life, deciding to try to get pregnant after 40 is a personal decision that has its own set of advantages and drawbacks: You may feel more ready and financially secure, for example, but at the same time, your chances of miscarriage, gestational diabetes, preterm birth, and other complications increase. If you’re having trouble conceiving spontaneously, a fertility specialist may be able to help.
IN THIS ARTICLE
- What are my chances of pregnancy after 40?
- Advantages of getting pregnant after 40
- Drawbacks of getting pregnant after 40
- How to get pregnant at 40
If you’re thinking about having a baby at 40, there’s no denying your odds of getting pregnant are significantly lower now than they were just a few years ago – about 1 in 10 women will conceive spontaneously around age 40, according to the American College of Obstetricians and Gynecologists. (After 45, experts say, it’s very unlikely you’ll get pregnant using your own eggs.)
Many 40-plus women do get pregnant, some using fertility treatments and some not. Data from the Centers for Disease Control and Prevention actually showed that the birth rate for moms aged 40-44 rose continuously between 1985 and 2019, at an average of around 3 percent per year.
Pregnancy at any age has its advantages and disadvantages, but here’s a picture of what to expect if you’re planning to try to get pregnant at 40 or beyond.
What are my chances of pregnancy after 40?
It’s possible, but almost half of women over 40 experience fertility issues, according to the CDC. Women over 40 have about a 5 percent chance of getting pregnant in any single ovulation cycle. (That’s compared to a 25 percent chance for women in their 20s and early 30s.)
At 40, your chances of getting pregnant within a year are about 40 to 50 percent. To compare, a woman in her mid-30s has about a 75 percent chance. And by age 43, a woman’s chance of getting pregnant within a year drops significantly to only 1 or 2 percent.
Why the steep drop-off? It’s all about the eggs. When you reach puberty, your eggs number between 300,000 and 500,000, and after that you lose about 13,000 of them a year. Over the years, this steady drop in egg supply leaves you with about 25,000 eggs by age 37 – the age that also coincides with a precipitous drop in fertility. By age 43, your egg supply is near its end. Your risk of pregnancy complications, such as high blood pressure and gestational diabetes, increases after 35 as well, and continues to rise into your 40s.
Miscarriage rates begin to skyrocket in your 40s as well. At 40, the average chance of a miscarriage is about 40 percent, and that rises to around 80 percent by age 45. The same underlying mechanism that causes miscarriage (an increased risk of extra or missing chromosomes in the embryo) also increases the risk of Down syndrome: At 40, your chance of conceiving a child with Down syndrome is one in 100; at 45, it’s one in 30.
Because the increased risk for abnormal chromosome numbers increases with maternal age, experts recommend that pregnant women in their 40s be offered detailed screenings for these abnormalities. This includes non-invasive tests such as cell-free fetal DNA blood testing and advanced ultrasound. Invasive tests, such as amniocentesis or chorionic villus sampling (CVS), are also available if needed. Genetic testing is always a choice, and your OB or midwife can give you a thorough explanation of your testing options, their implications, and their costs.
Mothers over 40 also have a nearly 50 percent chance of having a c-section as a result of delivery complications. Incidents of low-birth-weight and stillborn babies are higher as well.
One very positive fact on your side: Given the range of new assisted reproductive technology (ART) methods now available, there’s no better time in history to try to get pregnant in your 40s. Although in vitro fertilization (IVF) success rates fall significantly when women use their own eggs after age 35, the chance of success using donor eggs remains high with a pregnancy rate of about 50 percent for women through their late 40s.
For women in their 40s who use eggs from a woman in her 20s or 30s, the risk of miscarriage and chromosomal abnormalities is consistent with the age of the egg donor.
An OB-GYN shares what she wishes her patients would do before getting pregnant.
Advantages of getting pregnant after 40
Every woman has her own (very good!) reasons for her family-planning timing. There may be more reasons that are personal to you that explain why you’ve decided to try to get pregnant now, but these are a few of the potential benefits of waiting to become a parent (or adding another child to your family) when you’re older:
You’re more experienced. Probably the greatest advantage of waiting to have children is that you’ve had time to grow. You may be more secure financially and more comfortable in your career. It’s possible that you and your partner, if you have one, have had the chance to get to know each other in a variety of circumstances, which can be a solid foundation for raising a family.
Some studies have also asserted that older mothers are, in general, better educated than young mothers and make wiser parenting decisions. Mothers over 30 are also slightly more likely to breastfeed, according to the CDC.
You may be more financially secure. Waiting to have children might also have financial benefits, possibly as a result of being more established in your career. One study found that women who had children in their 40s were subject to less of a motherhood “wage penalty” than those moms who had children in their 20s and 30s.
Drawbacks of getting pregnant after 40
While conception, pregnancy, and labor and delivery complications may arise at any age, having a baby at 40 and beyond can increase the risks of some of those complications.
You may have a hard time getting pregnant. The biggest downside to putting off pregnancy until your 40s is significant: It’s harder to get pregnant the longer you wait. That’s because your egg supply decreases significantly as you age, and older eggs are more likely to have chromosomal problems, raising the risk of miscarriage and birth defects.
In one study, researchers found that 40-year-old women treated for infertility had a 25 percent chance of getting pregnant using their own eggs. By age 43, that number dropped to 10 percent, and by 44 it had sunk to 1.6 percent. Among women who did get pregnant, the miscarriage rate was 24 percent for 40-year-olds, 38 percent for 43-year-olds, and 54 percent for 44-year-olds. (Using donor eggs boosts the odds of getting pregnant considerably.)
You’re more likely to have a difficult pregnancy. Pregnancy complications are another concern. In your 40s you’re far more likely to develop problems like high blood pressure and diabetes during pregnancy as well as placental problems and birth complications.
You’re at higher risk of a small or preterm baby. Women older than 40 are more likely to deliver a low-birth-weight or preterm baby. Stillbirth rates are also higher, and studies have shown that children born to older mothers may be at slightly increased risk of type 1 diabetes.
Your partner’s sperm may be older, too. Although men are physically capable of fathering children in their 60s and even into their 70s, sperm quality deteriorates with age. Older men’s sperm has a higher rate of genetic defects than younger men’s sperm. Studies have suggested links between the father’s age and genetically related conditions such as schizophrenia and autism spectrum disorder.
You could strain your finances. There are financial advantages to waiting to have children, but there may be liabilities as well. If you wait, you may to have to continue working to an older age to afford childcare, or you may end up setting aside less for retirement because you have other expenses. Additionally, fertility treatments can be pricey.
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