Dr. Shannon Brim discusses the challenges of becoming pregnant at 40 and how to increase your chances.
TL;DR: Having a baby at 40 is absolutely possible, but fertility naturally declines with age. This blog answers the most common questions women have about getting pregnant later in life and shares doctor-recommended tips to improve your chances.
- Natural conception is possible: Women still have a chance of pregnancy at 40, though success rates per cycle are lower than in younger years.
- Egg quality and quantity matter: Ovarian reserve decreases with age, but testing like AMH can provide helpful insights.
- Healthy lifestyle choices help: Balanced diet, exercise, quitting smoking and drinking, and daily prenatal vitamins support fertility.
- Stress management is key: Practices like yoga, meditation, journaling, and good sleep hygiene can promote overall reproductive health.
- Male fertility plays a role too: Age, lifestyle, and health impact sperm quality, making shared healthy habits important.
In the 1970s, the average age of first-time mothers in the United States was 21. By 2020, that average age had jumped to 26. Studies show this trend is mostly due to career goals and financial concerns – children aren’t cheap!
Unfortunately, evolution has not caught up with the newer preference of becoming pregnant later in life. Our bodies face some unique pregnancy challenges as we age.
Having a baby at 40 or older is not always easy. That’s the case even if you feel perfectly healthy and capable of carrying a baby.
As obstetricians and gynecologists, we’ve seen an increase in patients asking us questions about getting pregnant at 40.
We thought we would address a few of the most common questions and offer some tips for getting pregnant at 40 or later.
Continue reading to learn doctor-recommended ways to increase your odds of getting pregnant at 40.
Is it possible to get pregnant naturally at 40?
YES! Fertility does decline naturally as we age, starting around age 30. However, it is possible to become pregnant without fertility treatments. (This is why we often recommend staying on birth control until menopause if pregnancy is undesired. If you are having periods, there is a chance you can get pregnant!)
The Odds of Getting Pregnant at 40
Fertility specialists quote approximately a 5% chance per menstrual cycle of getting pregnant naturally after age 40. Compare that to a 25% chance per cycle for women in their 20s. Your 20s are when fertility typically peaks and you have the best chance of experiencing healthy pregnancies.
The reason for the decline in successful pregnancies after 40 is multifactorial. A risk of miscarriage is the biggest concern. The rate of miscarriage is about 40% after the age of 40. The main reason is a higher chance of genetic abnormalities in each egg.
A women’s ovarian reserve also decreases over time. That means they naturally have fewer eggs by age 40.
How many eggs does a woman have at 40?
When girls are born, their ovaries contain the total number of eggs they will ever have. That’s about a million! This number declines as they age. Women lose about 30 immature eggs each day!
This means that by the time a woman reaches puberty her ovaries contain 300,000 eggs. By age 30, she’s down to 100,000. Estimates say that by age 40 women only have about 20,000 eggs remaining.
Can you find out how many eggs you have left?
Ovarian reserve can be tested by a physician. They’ll use a blood test called the Anti-Mullerian Hormone. AMH is a hormone produced by the follicles in a woman’s ovaries where egg cells develop. It declines throughout a woman’s reproductive lifespan.
The lower a woman’s AMH number, the fewer eggs remain in her ovarian reserve.
However, it’s important to remember that a woman’s AMH test results are just one piece of data. Her doctor will look at other results when discussing her fertility health, too. The AMH test won’t tell anything about the quality of her remaining eggs. Likewise, it can’t be used to predict a woman’s chances of having a successful pregnancy.
Are my eggs bad after 40?
All women have a percentage of eggs that are genetically abnormal. Even if those eggs are fertilized, the pregnancy may not end in a live or genetically normal baby. The percentage of normal eggs a woman has decreases as she ages. Thus, there are increased risks to pregnancy after 40.
- At age 25, a woman has approximately 75% normal eggs.
- By age 35, that number drops to around 45%
- By 40, it’s around 20-30%
This is one reason why most physicians recommend genetic testing. Such testing looks for conditions such as Trisomy 21 in pregnancy over age 35.
Is Having a Baby at 40 Too Old?
Many patients ask us if we think that 40 is too old to have a baby and raise a child. We simply say, “Do what feels right.” If you want to get pregnant at 40, we will do our best to help you reach that goal. We’ll provide the support you need to have the healthiest pregnancy possible.
We also want you to be aware that there are more challenges involved with pregnancy at 40 and older. Dr. Allison Giles discusses some of the risks for both mother and baby in her blog post, Odds and Risks of Pregnancy After 40. We encourage you to schedule a preconception visit with your doctor to discuss your personal risk. You’ll learn what you can do to minimize it even before you become pregnant.
How long does it take to get pregnant at 40?
At peak fertility, the odds of conceiving in any one month are about 20-25%. After a year of unprotected intercourse, approximately 85-90% of healthy couples will conceive. Couples under 35 who have not become pregnant in one year of trying should consider fertility testing.
By age 35, the chance of a successful natural pregnancy drops to 10-15% per cycle. By 40, the chances hover around 5%. This does not mean that getting pregnant after 40 is impossible. However, it will likely take longer.
That’s why the recommendation for considering fertility testing after 40 is only 6 months.
Does stress affect fertility after 40?
High stress levels may affect hormone balance and ovulation patterns at any age. At 40, when fertility is already lower, managing stress becomes even more important.
The encouraging part is that small, consistent steps can help. Consider taking up practices to reduce your stress levels as you navigate your fertility journey.
Examples include:
- Yoga
- Meditation
- Journaling
- Daily walks
- Breathing exercises
- Creative outlets like painting, gardening, music, or cooking
- Connecting with loved ones
- Limiting screen time
- Massage or acupuncture
- Good sleep hygiene
Support groups or counseling can also provide reassurance and encouragement during your journey.
Remember, stress alone won’t prevent pregnancy, but reducing it can improve your overall health. As a result, the process of trying to conceive may feel more manageable and positive.
How do I improve fertility after age 40?
There are many ways to improve fertility in general. They become especially important after age 40.
Another challenge women over 40 face is that many will have been diagnosed with other conditions. These conditions can cause pregnancy complications or more difficulties getting pregnant.
Examples are:
- Obesity
- High blood pressure
- Diabetes
- Thyroid disorders
- Fibroids
- Endometriosis.
Women with other medical conditions should make sure that their physicians know that they are trying to conceive. As a result, they can optimize their health to prepare for the pregnancy.
This may mean:
- Changing medications
- Working on eating healthy
- Exercising
- Weight loss (see Dr. Pound’s 4 Tips for Becoming Pregnant)
- Being more aggressive in controlling conditions like diabetes
A preconception counseling appointment with your regular gynecologist can help pinpoint areas for improvement. From there, your doctor can give you personalized recommendations.
It is also important to take a prenatal vitamin daily when trying to conceive. They help you get the nutrients needed for healthy development of a fetus.
Some reproductive endocrinologists also recommend supplementing with CoQ10 to help with egg quality. Learn more in Dr. Dogal’s blog post,
Everything You Want to Know About Prenatal Vitamins (Whether You’re Pregnant or Not)
Here are some tips for getting pregnant at 40 or older:
Try More Frequently During Your Fertile Window
One of the simplest ways to increase your chances is to try more often. Specifically, try during the times in your menstrual cycle when you are most fertile. Track your cycle and look for ovulation indicators. It’s the best way to understand when your fertile window will occur and increase your chances.
Eat Right
Obesity and a poor diet high intrans fats and processed foods can decrease your chances of getting pregnant. If you’re struggling to control your weight, talk to your doctor about some of the things you can do. Dr. Stephen Pound has some great tips.
Ditch Drinking and Smoking
If you’re drinking or smoking while trying to get pregnant, it’s recommended that you stop. Drinking alcohol and smoking will hurt your chances of conceiving. They can also negatively impact your odds of having a healthy, successful pregnancy.
The role of your male partner’s fertility
When couples talk about fertility after 40, the focus often falls on women. But it’s important to remember that male fertility also plays a role.
Men don’t experience the same sudden drop in fertility as women. Still, sperm quality can decline gradually with age.
Some common factors that may influence male fertility include:
- Age. Sperm quality can decrease with age, though often more gradually than egg quality.
- Lifestyle habits. Smoking, excessive alcohol use, and recreational drugs can negatively affect sperm.
- Weight. Being overweight or underweight may impact hormone balance and sperm health.
- Stress. High stress levels can reduce testosterone and affect sperm production.
- Diet and nutrition. A diet lacking in antioxidants, vitamins, and minerals can contribute to poorer sperm quality.
- Environmental exposures. Heat (like frequent use of hot tubs), radiation, and certain chemicals can reduce sperm count.
- Medical conditions. Diabetes, varicoceles, and hormone imbalances may affect fertility.
The good news is that many healthy lifestyle choices can improve a man’s reproductive health.
If you and your partner have been trying for six months, it may be worthwhile for both partners to undergo fertility testing. This allows your doctor to get a full picture of your reproductive health and recommend the best next steps.
Is there help if I haven’t gotten pregnant after 40?
YES! Reproductive endocrinologists specialize in assisting women with fertility issues. After age 40, we recommend having a consultation with a specialist. Make an appointment if you haven’t become pregnant within 6 months of trying.
There are many options for how to proceed depending on age and health history. You can go over these options together and figure out the best plan for you and your partner. We wish you the best of luck!
To schedule a preconception consultation with a VPFW provider, call VPFW at 804-897-2100 or message us to schedule online.
