Fertility in 40s

Many women nowadays are going for delayed child bearing. This is because women first want to get settled in their career, find the right partner and be in a mental space to get pregnant and raise a child. Thus, these are some of the advantages of being a mother in the forties. Nevertheless, there are some disadvantages as well.

Every woman has one million eggs from the time she is born till puberty. After puberty, it gets reduced to three lakhs. At the age of thirty-seven, only 25,000 eggs are left. Thus, though one maybe having natural cycles, follicular formation till the age of fifty, in the last five to ten years of a lady’s menstrual cycle, eggs are damaged and of poor quality and the chance of pregnancy is very low.To put this into perspective, suppose a woman in her early thirties, has a 20-30% chance of pregnancy per cycle, it goes down to 5% for a woman in her forties. Similarly, the rate of miscarriage, which is 10-15% at a younger age, goes as high as thirty to 30-35% at an older age. The risk of congenital malformation such as Down’s syndrome also increases and so does the risk of pregnancy like high blood pressure, diabetes, premature delivery and increased incidence of cesarean sections .

However, if the woman has decided to plan pregnancy in her forties, then one must keep a note of the lifestyle, be fit, eat healthy, stay away from addictions and visit a doctor. Supplementation of oneself as well as your partner is important in the form of DHEA, coenzyme Q, zinc, selenium and carnitine. A doctor will do a baseline investigations of the woman and her partner to assess the fertility status which is understandably low in her forties and to gauge the overall chances and best method forward. If natural conception has not been tried, usually few cycles are left for natural cycles, and then if things don’t work out, options of IUI and IVF are given. It is usually best to go with IVF and take the chances of this advanced fertility technique sooner than later. For many they are lucky in the first or the second attempt, many are not. They may need multiple cycles and embryo pulling for the final pregnancy to happen. Many are not successful despite all these methods and then may need to stop treatment, go for adoption or use donor eggs.

Thus, though it is best to try for pregnancy in your 20’s and early 30’s , many a times circumstances do not allow. A step by step approach should be followed under the guidance of a fertility expert and realistic expectations maintained.