More and more, women over 40 are contacting us for assistance in achieving natural conception and a healthy term pregnancy. Here is an example of what we commonly hear…

“I’m not sure if I can get help as I’m 45 years old and although I have never tried for a baby before as I never met anyone. I feel it might be too late to conceive naturally. Has anyone you have helped been successful in this? I want to feel positive but I may just be asking for more heartache….”

While these exact words may not ring true for all women who desire to have a child over 40, there is one line that brings up a fear ALL of these women have in common: “I feel it might be too late to conceive naturally.”

Is Natural Conception and Pregnancy Over 40 a Reality?

It is really challenging to say, as each woman is different in regards to her current health, health history and life circumstance. We do know that it is still possible for some women, generally in the 40-43 age range. Fertility over 40 declines naturally, therefore realistically, yes, the likelihood of natural conception over 40 is going to decline each year, as a woman moves closer to menopause.

Knowing your fertility status is the key to help you determine the likelihood of conception – natural or through medical assistance, with your own eggs, or not.

There are several things that need to be thoroughly thought through:

• The impact of age-related health on you and your child.
• Most women over 40 will need some sort of assistance to help achieve pregnancy.
• Modern statistical evidence of term pregnancies for women over 40, come from studies performed on women who underwent IVF, not women who conceived naturally. Researchers aren’t tracking natural conception over 40, it is just too challenging to track in large populations.
• The financial and emotional strain of fertility treatments.

Common fertility concerns for women over 40:

• Poor egg health
• Low ovarian reserve
• Hormone imbalance or hormone changes related to perimenopause and menopause
• The likelihood of natural conception
• Going for IVF
• Age cut-off for using own eggs for IVF
• Considering alternatives such as egg donor or embryo adoption
• Preparing for parenting at an older age
• Wanting a child, but still not finding the right male partner – sperm donation
• Increased risk of miscarriage
• Increased risk of birth defects or developmental problems for the child
• Infertility related depression, a sense of loss of control
• Increased risk of pregnancy related problems

What is the Likelihood of Conception over the Age of 40?

Doctors determine a woman’s ability to conceive naturally, or through IVF with her own eggs by running a hormone profile. If you are already 40, or over, and haven’t been to see a doctor to have a full hormone profile run, it’s time! Make that appointment right away. Knowing this information is critical, as time is of the essence. The reason this is so important is because it helps your doctor and other healthcare providers know the status of your egg health and ovarian reserve; two very important factors for conception. This will help you and your health care providers to know the best options for you to achieve pregnancy.

Follicle Stimulating Hormone (FSH)

FSH levels show us the quality of egg health and ovarian reserve. For women aged 20 – 35, FSH levels are typically between 5 and 20 IU/L throughout the menstrual cycle, peaking mid-cycle. Some doctors feel that a level higher than 10-15 IU/L indicates diminished ovarian reserve. According to the Center for Human Reproduction though, it is not as cut and dry as many clinics make it out to be:

“The younger the patient the better our chances will be to still achieve pregnancy with use of a woman’s own eggs even if FSH is high. Therefore if a woman in her 20s has an FSH in the 20s, not great, but she still likely will end up conceiving … with our treatment approach the same high FSH level in a 43 – 44 year old is much more ominous, therefore what represents a maximum FSH level is relative depending on age and other surrounding factors. Approximately 1/3 of women who come to us because they were told that their only chance of pregnancy is through donor eggs leave us pregnant with the use of their own eggs, so a minority but still quite a significant portion of patients with very, very poor ovarian reserve and usually quite high FSH with appropriate treatment at CHR will still have a very decent pregnancy chance.” – Norbert Gleicher, MD Center for Human Reproduction, NY, NY.

Basically what Dr. Gleicher is saying, if you have very high FSH levels and are over the age of 40, the likelihood of achieving pregnancy with your own eggs is going to be very challenging.

Anti-Mullerian Hormone (AMH)

This test is used to determine ovarian reserve. Low to very low levels (0.1 – 0.6 ng/ml) are used to help a doctor decide if a woman is a good candidate for IVF, or for other treatment. The lower the numbers, the lower the ovarian reserve and the lower the chances of successful stimulation of enough follicles for IVF.

Estrogen and Progesterone

While FSH and AMH help determine egg health and ovarian reserve, low or imbalanced levels of estrogen and progesterone may indicate troubles with implantation. Should a woman achieve conception, but have poor estrogen or progesterone levels, miscarriage is likely to occur due to an inadequate uterine lining.

The good news is that for many women, hormone levels can be positively influenced through improved nutrition, healthy lifestyle changes and specific natural therapies. A great place to begin is by reading our hormone health guide…

Why Fertility Doctors Often Turn Women Over 43 Away

Many fertility clinics are hesitant or will not work with women over a certain age. They determine this by the statistical success rates they track each year. They wouldn’t suggest this upper age limit, if women with advanced maternal age were achieving higher live birth rates.

Consider this…

• IVF age limits may be different at each clinic.
• The general age limit for use of a woman’s own eggs for IVF across the US is between the age of 42 and 45.
• Most IVF clinics will help women through the age of 50, if they choose to use donor eggs or embryo adoption.

According to the Advanced Fertility Center of Chicago, “At the age of 44 and above there are almost never babies born from IVF using the female’s own eggs – the success rate using eggs over the age 44 is about 1% per attempt.”

Achieving Pregnancy Over 40

“I have read the statistics, I have read about some women achieving natural conception in their mid to late forties and even early 50s, I believe that it is possible for me. Basically all the doctors are saying they can’t help me, I am too old. Can you help me?”

For women over 40 who contact us and/or choose to work with us through our private consultation program, we may suggest they work in conjunction with a medical fertility specialist who is skilled in alternative reproductive technologies (ART) such as IVF, ICSI and even possibly egg, sperm or embryo donor (adoption) clinics. We strive to provide our clients with a well rounded perspective that will give them all the options for actually achieving their goal – to become pregnant and to become a parent.

Realization that natural conception and pregnancy may not happen can be heartbreaking, but according to all the couples we work with, it is best to try, than not try at all. Take the time to properly prepare for pregnancy. We encourage all people we work with to have an open heart and mind! It is a very valuable tool to be level headed when making the decision to become a parent and reviewing all the options for your age group in achieving that goal!

Click here to learn about the many paths to parenthood that are available for infertility…

Only you can determine what is best for your life and for your body. Should you choose to move forward and have a child of your own, that is your very personal choice.

We strive to support women’s health, on all levels and if a woman wants to try for a baby over the age of 40, we are here to help them improve their health to increase their chances of a healthy pregnancy and baby – however that is achieved.

Click here to learn the healthiest ways to prepare for conception over 40…

References:
1. Fertility After Age 40 – IVF in the 40s. Advanced Fertility Center of Chicago. Retrieved on December 16th, 2014 from: http://www.advancedfertility.com/fertility-after-age-40-ivf.htm
2. Pregnancy after 40. Center for Human Reproduction. Retrieved on December 16th, 2014 from: https://www.centerforhumanreprod.com/infertilityedu/causes/pregnancy_over_40/
3. Sherbahn, Richard, MD. Anti-Mullerian Hormone Testing of Ovarian Reserve. Advanced Fertility Center of Chicago. Retrieved on December 16th, 2014 from: http://www.advancedfertility.com/amh-fertility-test.htm
4. Twenge, Jill. How Long Can You Wait to Have a Baby? The Atlantic. (July/August 2013). Retrieved on December 16th, 2014 from: http://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/