Getting pregnant in your 40s: What you should know
In Hollywood, more and more celebrities seem to be having babies in their 40s. Kelly Preston had a son at age 47, Halle Berry is expecting again at age 46, Susan Sarandon gave birth at ages 42 and 45, Celine Dion had twins at age 42, and the list goes on.
While Dion admitted to having help from modern medicine, many other famous women who are currently or recently pregnant have also had fertility assistance, says Carol Wheeler, MD, a reproductive endocrinologist in the Center for Reproduction and Infertility at Women & Infants Hospital and a clinical associate professor in the Department of Obstetrics and Gynecology at The Warren Alpert Medical School of Brown University.
"Unfortunately, some of these women are not comfortable sharing that information because it can be very emotional," Dr. Wheeler says. "They may be embarrassed to talk about techniques such as using an egg donor. We see the emotional and stressful side of fertility treatment every day. It can be a long road to achieve the dream of a family, but it is definitely worth fighting for it."
Chances are …
According to The Center for Disease Control and Prevention, births for women aged 40 to 44 increased 10% from 2007 to 2011. But, overall, pregnancy rates do decline from the mid 30s on.
"Some women are still fertile in their early 40s, but many of them have great difficulty conceiving," Dr. Wheeler says. "This is due to both a decrease in the number and the quality of a woman's eggs."
In addition, miscarriage rates increase quickly in women who are 40 plus. By the mid 40s, they are more than 50%.
"The problem is that the chromosomes in the egg become 'sticky' over time and don't always separate normally," Dr. Wheeler explains. "This leads to the possibility of the egg not having the correct number of chromosomes."
In addition to having difficulty getting pregnant, being older also increases the risk for problems during pregnant. Older women who are pregnant are more likely to have high blood pressure, preeclampsia, diabetes and cesarean sections. Ectopic (tubal) pregnancy rates are also higher in this age group.
"These women may need more careful monitoring during pregnancy, labor and delivery," Dr. Wheeler says.
Babies of older moms are at a higher risk for chromosomal problems such as Down syndrome, birth defects, pre-term delivery and stillbirth.
Take action now
If you're in your 40s and thinking of getting pregnant, Dr. Wheeler recommends that you:
- Maintain a healthy weight
- Don't smoke
- Don't abuse alcohol
- Don't take recreational drugs
- Make sure all of your health conditions are well controlled on medications that are safe to take if pregnant
- Get all of your immunizations up to date, including the flu vaccine
- Take a daily multi-vitamin with folic acid (400 micrograms)
When to get help
A woman in her 40s who is attempting pregnancy has many options.
"Some are very simple and straightforward, while others are much more complicated," Dr. Wheeler says. "The most important thing is to be completely evaluated so the couple can decide the best treatment for them."
Depending upon the situation, pregnancy may occur quite quickly. Alternatively, a couple may need to use very high-tech treatments, or even an egg donor.
Women ages 35 to 42 should see a fertility specialist after six months of trying to get pregnant (compared to after one year for younger women). Women over age 42 should consider seeing a fertility specialist after an even briefer time, Dr. Wheeler advises.