Experiencing pregnancy or having a baby as an older woman can be more challenging but may still be possible with modern fertility treatments and expert care.
Age is the biggest factor impacting female fertility. Women of advanced maternal age are those who are 35 years or older at the time of giving birth or receiving fertility care. Older age is associated with a decline in egg quantity and quality, and can make conception more difficult. If you are aged 35 or over and have been trying to conceive for six months or more, seeking timely specialist advice can maximise your chances of falling pregnant.
Women hoping to fall pregnant at age 40 or older are encouraged to seek advice as soon as they want to conceive, as the likelihood of falling pregnant per month declines dramatically at this age. While it is still possible to have a healthy pregnancy, getting pregnant after 40 can carry increased risks such as low birth weight, miscarriage, pregnancy complications, and risk of having a child with chromosomal abnormalities.
Fertility assessment for older mothers is similar to that for any woman undergoing testing for infertility. There may be a greater focus on your general health, as pregnancy in older age does come with increased risks to both you and your growing baby.
Some of the fertility tests that may be recommended include:
Anti-Mullerian hormone (AMH), an indicator of your ovarian function and reserves, may be measured with a blood test. This can provide guidance on the most appropriate fertility treatment, and help to establish realistic expectations. A hormone assay of other hormones critical for a healthy pregnancy can also be assessed via a simple blood test.
Pelvic ultrasounds are used to examine your reproductive organs for concerns such as fibroids, polyps or other anatomical issues that may affect conception or implantation. In certain cases, Dr Parmar may recommend more invasive diagnostic testing, such as a laparoscopy.
If you are conceiving as a couple, your male partner may also have testing with a semen analysis. This enables Dr Parmar to take into account and plan around any male fertility factors that may be affecting conception.
If you are aged over 35 and have been trying unsuccessfully to conceive for six months or more, timely fertility specialist care can offer the highest chances of a positive outcome as egg quality and quantity continue to decline, and with it, rates of success for fertility treatment. Despite this, a fertility treatment plan considering your age, reproductive health, and medical history can still result in pregnancy and a healthy baby.
Fertility treatments for women of older age include:
If the main fertility issue identified is related to irregular or absent ovulation, medications such as injections of follicle-stimulating hormones (FSH) may stimulate ovulation to improve the predictability of releasing an egg each month. However, this treatment tends to be less effective for older age groups, as egg quality continues to deteriorate, and is not recommended for women over the age of 45.
Assisted reproductive technologies such as IVF and ICSI provide a greater degree of control over the fertilisation process, and can be used to overcome a number of infertility factors. IVF and ICSI also provide the opportunity to undertake preimplantation genetic testing or fertility treatment with donor eggs.
As the risk of chromosomal abnormalities in an embryo can increase with age, PGT may be recommended alongside IVF/ICSI to ensure only chromosomally normal embryos are selected for transfer and pregnancy.
For older women with significant concerns about egg quality or quantity, using donor eggs, typically from a younger woman, may be a promising option. An egg donor may be someone personally known to you, such as a sister or friend, or someone recruited through a fertility clinic, such as Genea’s egg donor program.
