As women get older, one of the big questions on their minds is whether their eggs are still viable for getting pregnant and having a healthy baby. By the time a woman reaches her 40s, there are some important considerations regarding egg quality and the chances of conception.
What happens to egg quality with age?
A woman is born with all the eggs she will ever have – about 1 to 2 million eggs at birth. By puberty, this number drops to about 300,000 to 500,000 eggs. With each menstrual cycle, about 1,000 eggs are lost. By age 30, a woman’s supply of eggs has declined to between 75,000 and 300,000.
Not only does the number of eggs decline with age, but also the quality of the eggs. Here’s what happens:
- As a woman ages, the chromosomes of her eggs can experience problems replicating properly, leading to an increased risk of chromosomal abnormalities. This can raise the risk of miscarriage and conditions like Down syndrome.
- The older a woman gets, the more likely her eggs contain genetic mutations that can cause issues with fertility and fetal development.
- Egg quality starts to take a more significant decline around age 35. By 40, about 95% of a woman’s remaining eggs are abnormal or have genetic issues.
- Eggs have higher levels of proteins and free radicals that can negatively impact fertilization and embryo development.
- Older eggs have less ability to repair damaged DNA.
- Mitochondria in eggs produce less energy as a woman ages, impairing development.
While egg quality declines with age, women in their 40s can still get pregnant and have healthy babies, especially with the help of fertility treatments. However, the chances of conception and pregnancy risks do rise with age.
What are the pregnancy risks at age 44?
Women aged 44 and older are considered to have advanced maternal age. Pregnancy after age 35 is associated with increased health risks, but those risks rise more significantly after 40 and even more after 44. Some key risks include:
- Miscarriage – The risk of miscarriage ranges from 33% at age 40 to over 50% by age 44. Miscarriage rates continue to rise as women age.
- Chromosomal abnormalities – Older eggs have a higher risk of chromosomal problems. At 44, there is about a 1 in 20 chance of having a baby with Down syndrome versus 1 in 1,250 at age 25.
- Ectopic pregnancy – The rate of ectopic pregnancies increases with age, almost doubling from age 35 to 44.
- Placental problems – Older women have a higher risk of issues like placenta previa and placental abruption.
- Preeclampsia – Age raises the odds of developing dangerously high blood pressure and organ damage during pregnancy.
- Gestational diabetes – The risk of this pregnancy-related high blood sugar problem doubles at age 35 and continues to rise.
- Stillbirth – Stillbirth rates start increasing after age 35, with the risk almost doubling again by age 44.
- Low birth weight – Babies of older mothers are more likely to be born prematurely and/or have a low birth weight.
- Cesarean delivery – The rate of C-sections increases with age due to increased health risks.
What are my chances of getting pregnant naturally at 44?
A 44-year-old woman still releasing eggs has about a 1 to 2 percent chance of getting pregnant naturally every cycle. That may seem low, but pregnancy is still possible without fertility treatment at this age. Here are some statistics:
- At age 43, there is a 3% chance of getting pregnant naturally.
- By age 44, the natural conception rate drops to about 1.5% each cycle.
- By the mid-40s, there is less than a 5% total chance of getting pregnant without medical intervention.
While not impossible, getting pregnant after 44 without assistance is challenging. But there are steps women can take to try to improve egg quality:
- Eat a nutritious diet high in fertility-boosting foods.
- Maintain a healthy BMI.
- Quit smoking.
- Limit alcohol and caffeine.
- Reduce stress through yoga, meditation, etc.
- Take supplements like CoQ10 that may aid egg quality.
Seeing a fertility specialist for an evaluation is also recommended when trying to conceive after age 35. They can assess ovarian reserve, hormone levels, and whether assistance like IVF may be needed.
What fertility treatments can help at 44?
Thanks to major advances in assisted reproductive technology (ART), women in their 40s now have much higher chances of conceiving with medical help. Some fertility treatments to consider at age 44 include:
- IVF – The most effective option, it involves harvesting mature eggs and fertilizing them with sperm in a lab to create embryos.
- Donor eggs – Using donated eggs from a younger woman can significantly increase success rates, with up to a 55% live birth rate at 44.
- PGD – Helps select genetically normal embryos to transfer and avoids passing abnormalities.
- Surrogacy – Another woman carries the pregnancy to term, reducing health risks.
- Fertility-enhancing drugs – Medications can help stimulate better egg production in the ovaries.
Talking to a reproductive endocrinologist about optimal fertility treatments for your goals and circumstances can help maximize your chances if trying to get pregnant at 44.
How do my chances compare to a younger woman?
A 44-year-old woman trying to conceive is at a clear disadvantage compared to younger women in her 20s and early 30s. Here is how natural conception odds typically compare by female age:
| Female Age | Chance of Conceiving Naturally Each Month |
|---|---|
| 25 | 20-25% |
| 30 | 15-20% |
| 35 | 10% |
| 40 | 5% |
| 44 | 1-2% |
Younger women’s higher egg count and quality gives them better odds of conceiving quickly. But a 44-year-old can significantly boost her chances through IVF with donor eggs, yielding success rates closer to a 30-year-old’s.
What do success rates look like at 44 with fertility treatments?
Using her own eggs, a 44-year-old woman has less than a 5% chance of getting pregnant and having a live birth with IVF. But her chances improve dramatically using eggs from a younger donor:
| Age | Live Birth Rate with IVF Using Own Eggs | Live Birth Rate with IVF Using Donor Eggs |
|---|---|---|
| 35 | 23.6% | 55.1% |
| 40 | 13.6% | 48.7% |
| 44 | 4.1% | 55.1% |
With donor eggs, live birth rates can approach those of a 35-year-old woman. Still, at age 44 risks like miscarriage, high blood pressure, gestational diabetes, and other complications are higher regardless of conception method.
What does egg/embryo freezing do for my chances?
Freezing eggs or embryos at a younger age for use after 44 can also substantially increase chances compared to using fresh eggs. Here are some approximate live birth rates at 44 based on different egg sources:
- Fresh own eggs: 2-4%
- Frozen own eggs (frozen at 35): 7-12%
- Donor eggs from 21-year-old: 55%
- Donor eggs from 30-year-old: 45%
Ideally, freezing eggs before 35 provides the best odds later on. But frozen donor eggs remain much more viable than fresh eggs from an older woman. Speak to a fertility specialist in your mid-30s if considering egg freezing.
Should I consider using a gestational carrier?
Having a gestational carrier (surrogate) carry the pregnancy for you is another option at an older maternal age. A gestational carrier allows you to experience pregnancy without undergoing the strain and risks of carrying a child yourself in your 40s. Key advantages include:
- Avoiding higher odds of complications like gestational diabetes and preeclampsia.
- Reducing the risks of miscarriage or placental problems.
- Increasing the chances of having a healthy, full-term birth.
- Lowering the need for a C-section due to age-related risks.
Surrogacy arrangements take time and have costs, legal considerations, and emotional factors to weigh. But it can be a rewarding way for older intended mothers to have a biological child when pregnancy poses higher risks.
What are the costs involved with getting pregnant at 44?
Getting pregnant in your 40s often involves some level of fertility treatment, which can add up in costs. Here are some approximate ranges for common options:
- Basic IVF cycle: $8,000 – $15,000
- IVF with donor eggs: $25,000 – $35,000
- Surrogacy: $90,000 – $130,000
- Egg or embryo freezing: $5,000 – $8,000 per cycle
- Medications: $2,000 – $5,000 per cycle
Keep in mind, costs vary widely by clinic and region. And it often takes multiple cycles to achieve success, so expect expenses to be higher. Health insurance, loans, grants, and financial programs may help offset costs if finances are a concern.
What are the potential health impacts of pregnancy after 44?
In addition to higher risks during pregnancy, women who conceive later in life are more likely to develop certain health conditions after giving birth. Some potential impacts include:
- Increased odds of developing gestational diabetes, which raises your risk for type 2 diabetes later on.
- Higher risk of high blood pressure disorders like preeclampsia, which can contribute to heart disease risk after pregnancy.
- Greater likelihood of Caesarean delivery, which presents more complications in subsequent pregnancies like placenta accreta.
- Higher rate of postpartum depression.
- More urinary incontinence issues.
- Potential for premature ovarian failure after pregnancy.
- Greater feeling of fatigue, exhaustion, and physical strain from child-rearing at an older age.
Pregnancy and childbirth are stressful at any age. But entering motherhood later in life tends to have more difficult effects on long-term health. Staying fit, eating well, and getting rest can help minimize impacts.
What are the potential risks to the baby when getting pregnant at 44?
In addition to higher miscarriage rates, babies conceived to older mothers have some increased health risks including:
- Higher chance of chromosomal abnormalities like Down syndrome.
- Greater likelihood of low birth weight and preterm delivery.
- Increased risk of developing diabetes, high blood pressure, or heart disease later in life due to womb environment.
- Potential for delayed development or intellectual disabilities.
- Higher rates of autism and schizophrenia.
However, the vast majority of babies born to women 44 and over are still healthy. Following doctor’s orders and a healthy lifestyle during pregnancy can help minimize risks.
How might having a baby later impact my child and family?
Being an older parent can impact your child and family life in some ways, including:
- Having less physical energy to keep up with young kids
- Increased strain on your finances providing for a child later in life
- Higher risk of losing parents/grandparents early in your child’s life
- Potential judgment from family or friends about your decision to have kids later
- Missing out on some social activities with younger parent peers
- Facing assumptions you’re a grandparent instead of the parent
However, being an older parent has benefits too – more wisdom, financial stability, life experience, and appreciation of parenthood. Staying active and focusing on your child are what matter most.
Conclusion
Having a baby in your 40s is more challenging but still possible, especially with medical assistance. While risks and costs increase after age 44, the odds of getting pregnant and carrying successfully can improve with steps like egg donation, embryo freezing, and having a gestational carrier. Being in the best health possible and working with a great medical team can help maximize your chances while minimizing risks in your 40s and beyond.
