If you're over the age of 35 and trying to get pregnant, you may have heard that it can be more difficult to get pregnant if you are 35 or older. Many people are choosing to delay pregnancy until their 30s and beyond and are successfully delivering healthy babies. While conceiving after 35 may require some patience and understanding of your fertility window, it is usually possible to have a baby after age 35 until whenever menopause sets in.
Age 35 isn’t a magical number where fertility rates suddenly plummet; however, it’s good to be informed about the age-related progressive decline in fertility and other factors that influence fertility as we age. The overall birthrate in the United States may be dropping among those in their 20s, but there has been a significant increase in people giving birth at age 35 and older in recent decades. In this article, we'll explore the steps you can take with your healthcare provider to address common questions about conceiving after age 35.
Age plays a significant role in fertility for all genders. While it is true that fertility declines with age, it is important to remember that many individuals successfully conceive and have healthy pregnancies after age 35. Women or people assigned female at birth (AFAB) in their early 20s have the highest fertility rates, and miscarriage rates are relatively low in this age group. Fertility gradually declines in a woman's 30s, with a more significant drop after age 37.
The chance of conceiving during a menstrual cycle decreases from 20-30% for people in their 20s to around 15-20% for people in their early 30s, and miscarriage rates start to increase progressively the older someone is. Fertility declines more significantly in females after age 40, and the chances of conceiving per menstrual cycle are around 5% or lower. This doesn’t mean that you can’t get pregnant after your 20s, it just may take longer– 82% of women ages 35 to 39 were pregnant after 1 year (12 cycles) of trying and 90% of women were pregnant after 2 years (24 cycles).
While much of the focus is on female fertility, male fertility also declines with age. Men and people assigned male at birth (AMAB) in their 40s and older may experience a decline in sperm quality, leading to decreased fertility and an increased risk of genetic abnormalities in offspring.
It's essential to remember that these statistics are general trends and that individual experiences may vary. Some may conceive easily at an older age, while others may face challenges in their younger years.
While the path to parenthood is filled with hope and excitement, it's good to be aware of the factors that can impact fertility as we age. Individuals may face some unique challenges, but remember, you are not alone in this journey, and understanding the complexities of fertility can empower you to make informed decisions about your reproductive health.
As women and people AFAB age, the number and quality of their eggs decline. This makes it more challenging to achieve pregnancy. A decline in egg quality and advanced maternal age can increase the risk of miscarriage and raises the chances of chromosomal abnormalities in the baby.
With advancing age, women and people AFAB may be more prone to certain medical conditions that can affect fertility, such as endometriosis, fibroids, or polycystic ovary syndrome (PCOS). These conditions can impact the ability to conceive. There is also an increased risk of pregnancy complications in general when older, and these risks can affect the body’s ability to carry a pregnancy to term.
Ovarian reserve refers to the number of eggs available for fertilization. After age 35, the ovarian reserve starts to decline at a faster rate, reducing the chances of conception. Females/people AFAB are born with all the eggs they’re going to have, and by about age 37, 90% of the eggs are gone.
While much of the focus is on female fertility, it's important to note that male fertility can also be affected by age and make it harder to get pregnant. Advanced paternal age may lead to decreased sperm quality and an increased risk of genetic abnormalities.
Schedule a visit with your healthcare provider (one that is experienced in fertility and reproductive health) when you are ready to start trying to conceive (TTC). They can assess your individual health, discuss any potential concerns, and provide guidance on optimizing fertility. This may include lifestyle modifications, nutritional recommendations, and potential medical interventions.
The latest guidelines in most countries state that women over the age of 35 should seek out a fertility evaluation if they have been trying to conceive for six months, but this does not mean you cannot seek out a conversation about fertility with your healthcare provider before the six-month mark. In fact, I encourage you to start the conversation when you begin trying to conceive. There are a lot of factors besides age that can affect your fertility, and it's often worth your time to start the conversation early in your journey.
Considering using an at-home fertility screening test when you’re starting out. There are tests you can use over the counter at home that screen certain elements of both female and male factor fertility. *affiliate link?
Understanding your menstrual cycle and tracking ovulation can help identify the most fertile days, as only one egg drops monthly during a cycle. Conception is only possible during the fertile window, therefore, intercourse should happen during this window if you want to make it count. There are various methods and tools available, such as ovulation predictor kits and fertility tracking apps, that can assist in identifying the optimal timing for intercourse.
Adopting a healthy lifestyle is crucial for optimizing fertility at any age. Both male and female fertility is affected by lifestyle. This includes maintaining a balanced diet, engaging in regular physical activity, managing stress levels, getting adequate sleep, and avoiding harmful substances such as tobacco, drugs, and excessive alcohol consumption.
If you are over the age of 35 and conception does not occur naturally after six months of trying (purposeful intercourse timed within your fertile window), experts recommend you make an appointment to discuss with your healthcare professional for a fertility evaluation (however, you can ask for this from your healthcare provider at any point in your conception journey). They may refer you to a fertility specialist. Fertility specialists can discuss things like fertility testing and fertility treatments. Treatments such as in vitro fertilization (IVF) and intrauterine insemination (IUI) may be discussed with you, and assisted reproductive products at home may be options to explore; however, rates of success with IVF and other methods also drop with advancing age.
Consulting a fertility specialist can provide personalized guidance and tailored treatment plans based on your specific circumstances. If you are over the age of 40, it’s generally recommended that you start with a fertility screening appointment when you first start trying to conceive. We have some resources about preparing for a fertility consultation with a specialist.
Trying to conceive at any age can be an emotional journey, but it can be particularly stressful for those who are facing challenges due to age-related factors, as it can often take longer to conceive the older we get. It’s important to acknowledge the emotional impact the process is having on you. Seeking emotional support from loved ones, joining support groups, or seeking guidance from a mental health professional can provide a valuable source of encouragement and help manage stress and anxiety throughout the journey.
While the odds of conceiving right away may decline with age and pregnancy at an older age may be considered more high risk in certain ways, it’s crucial to remember that many people get pregnant successfully after the age of 35. Every individual's fertility journey is unique. Fertility and pregnancy complications can happen at any age, and so can successful pregnancies. Empower yourself with knowledge, take proactive steps to optimize your fertility, and trust in the support and guidance available to you. Remember, age is just one factor in the complicated biological process of conception for which many factors are involved.
Take the time to understand the factors that affect your fertility, and take proactive steps to enhance fertility in the ways that you can control. Seek emotional support for the factors you can’t control. Remember, you are not alone on this journey, and there are resources and medical professionals available to provide guidance and support along the way.
Disclaimer: This article is for informational purposes only and should not replace professional medical advice. It is always recommended to consult with a qualified healthcare provider for personalized guidance and fertility evaluations.
References:
Harper J. Launch of a global fertility education poster campaign Global Women Connected; (2019). Retrieved from:http://www.globalwomenconnected.com/2019/10/fertility_ed/?sfns=mo
The Cleveland Clinic. Male Infertility (2023). Retrieved fromhttps://my.clevelandclinic.org/health/diseases/17201-male-infertility
American Society for Reproductive Medicine. (2023). Age and Fertility: A Guide for Patients. Retrieved fromhttps://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/defining-infertility/
Reed, J. New York Presbyterian. Health Matters. A Guide to Pregnancy After 35 (2023.) Retrieved fromhttps://healthmatters.nyp.org/a-guide-to-pregnancy-after-35/
The Society of Obstetricians and Gynaecologists of Canada. Journal of Obstetrics and Gynaecology Canada. (Volume 34, Issue 1, 2012, Pages 80-93). Delayed child-bearing. Retrieved fromhttps://pubmed.ncbi.nlm.nih.gov/22260768/
American College of Obstetricians and Gynecologists. (March 2014). Female Age-Related Decline (No. 589). Retrieved fromhttps://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/03/female-age-related-fertility-decline
Obstetrics & Gynecology (103(1):p 51-56, January 2004). Increased Infertility With Age in Men and Women. Retrieved from DOI: 10.1097/01.AOG.0000100153.24061.45
