If you are a woman 40 or over and you want to have a baby naturally using your own eggs, you are fighting an uphill battle. Good news is that although your chances of becoming pregnant naturally are much lower than a younger woman’s, it’s still possible. You’ll need to do everything you can to ensure success, and this means getting as healthy as possible. Let’s discuss what can really make a difference and provide you with the best fertility tips for women over 40.
How to Increase Your Chance of Conceiving in Your 40s
Once a woman is over 35 years of age, the science shows, and researchers and fertility experts confirm, she has only about a 15 to 20 percent chance of getting pregnant naturally. To overcome these odds, a woman has to be very, very healthy which means an optimal BMI (body mass index), hormone levels, egg quality, a healthy immune system, stress is under control and low inflammatory levels. In short, all of these factors have to be lined up so that when (and if) she does finally release a good egg, a good sperm can make its way to that egg to make a high-quality embryo. So what else besides having a healthy lifestyle can help a woman over forty get pregnant?
To increase your chances of becoming pregnant, have sex! This sounds self-evident, but many women who are over 40 and trying to become pregnant don’t realize they need to up their frequency of intercourse. Have sex not just twice after the OPK (ovulation predictor kit) says you are in your high fertile days, but also once your period stops. Some fertility researchers are suggesting sexual intercourse every 2 or 3 days throughout the menstrual cycle.
So what does this mean? If you are not having your period, go for it. Instead of overworking or focusing on marathon training or cross fit (hey, this is LA!), try having date nights, and get your energies aligned so the chances for intercourse are higher. These same researchers state that this is also good for hormones too, which are definitely needed when one is TTC (trying to conceive).
Avoid Strenuous Exercise
This tip sounds counterintuitive as regular exercise is recommended as a vital part of keeping yourself healthy. Exercise in moderation is ok, but too much strenuous exercise can disrupt your menstrual cycle. So if you are a dedicated “gym rat” you might want to tone it down a bit while you are trying to conceive. Walking, swimming and cycling are all good choices.
If you smoke, stop! Most women know that smoking is not good for their health but some women who smoke say they plan to quit only after they become pregnant. What they don’t realize is that smoking, while definitely harmful to both mother and baby, is also negatively affecting their ability to conceive. Consider this: women who are regular smokers will go into menopause a full two years earlier on average than women who don’t smoke.
Ditch the Alcohol
Like smoking, many women plan to give up alcohol once they become pregnant. Again, they don’t realize that alcohol could be the culprit behind their inability to conceive. Having just three glasses of wine a week can have a negative effect on your ability to become pregnant. This negative effect of alcohol on fertility goes for men too! Alcohol consumption can negatively affect sperm by decreasing motility, and altering their shape, size and numbers. Heavy drinking can also lower a man’s testosterone levels and affect other hormones that in turn reduce sperm production.
Take Your Vitamins
Yes, vitamin supplementation is extremely important during pregnancy, but making sure your vitamin levels are optimal can also boost your chances of conception. Both Vitamin D as well as folic acid are essential nutrients. Plus, if you are a vegetarian or vegan, you’ll need to be aware that getting enough B12 and iron can be difficult through food sources alone. Some fertility specialists also recommend taking supplemental CoQ10, a powerful antioxidant that has been shown to increase egg quality.
Get Quality Sleep
Your egg quality as well as your fertility is directly related to quality sleep. During sleep, your body is repairing your cells, replenishing your energy and producing hormones that are vital to your reproductive organs. In addition, your brain produces the hormone melatonin that not only promotes sleep, but maintains your biological clock and can also be beneficial for egg quality. Because melatonin levels decrease as you age, you want to use natural methods to increase your body’s melatonin production, such as moderate exercise, morning sun exposure for a few minutes each day on your face without sunglasses or contacts, keeping stress under control and eating a healthy, whole foods, nourishing diet.
Get Known Medical Problems Under Control
If you have a chronic condition such as thyroid dysfunction, Type 2 diabetes, or high blood pressure, then these conditions and their associated medications need to be carefully regulated and monitored to be sure the condition is tightly controlled. Consult with your internist to make sure these medical problems aren’t in need of a tune up!
While the jury is still out on acupuncture’s ability to actually facilitate conception, it can help to restore the body’s overall balance. Some of the ways acupuncture works to do this includes helping to balance hormones as well as regulate the menstrual cycle, reducing stress and anxiety (which can affect your ability to conceive), improving blood flow to reproductive organs, and can also improve both the numbers and motility of sperm. In women who choose IVF (in vitro fertilization), acupuncture treatments have been shown to increase the chances of pregnancy.
Make an Appointment With a Fertility Specialist
So what else can you do? We know this sounds clinical, but the next step you can take is go beyond your GP or OB-GYN and see an actual fertility specialist. At the very least, set up an appointment. This can reduce stress, fear and anxiety around conception, and damping down these concerns is actually really helpful for getting pregnant. Then, if you are not pregnant after 4-6 months of trying, you (and your partner, if you have a partner) can go in and find out what’s really going on.
If the problem is just your age, or there is a sperm issue, or an underlying thyroid or autoimmune disorder, or a variety of other problems that could be causing you not to become pregnant, then all of the information you can get will be needed to help you make sound decisions. If one or more of these problems can be treated, then great. But if your eggs are just not viable, then you’ll want to consider getting help via reproductive technology.
When to Move on to IVF
Since IVF is the most effective method for achieving a pregnancy, it’s never wrong to turn to IVF. However, since IVF is expensive and involves hormonal injections and a surgical procedure to retrieve eggs, most patients would rather start with simpler and less expensive options, such as using timed intercourse plus Clomid, a drug that stimulates ovulation, in addition to intrauterine insemination (IUI), a procedure that places sperm directly into the uterus using a small catheter.
There are circumstances when these simpler approaches to fertility should be abandoned in favor of IVF, which consists of manually retrieving a woman’s eggs that are then exposed to the partner’s sperm in a laboratory vessel. The resulting embryo is then transferred to the woman’s uterus.
Among the clearest indications for early entry to IVF are severe male factor infertility and blocked fallopian tubes. For male factor infertility, individual sperm can be injected directly into the egg (ICSI) to help overcome semen analysis deficiencies. For blocked tubes, eggs are retrieved directly from the ovary and the embryos created from those eggs transferred directly to the uterus, thus bypassing the damaged tubes. There are also hereditary and genetic conditions that warrant an early move to IVF.
For women less than 35 years of age, who have a 20% chance of conceiving per month, IVF should be considered after 1 to 2 years of timed intercourse and clomid plus IUI. For women over 35 years of age, who have a 5 to 15% chance of conceiving per month, IVF should be considered after six months to one year of the above treatment. For more information on IVF, please see this page.
When is it Time to Consider Donor Eggs?
Knowing when to move on to egg donation is always difficult and is ultimately a personal decision based on when that individual woman feels she is ready to move on. Women using their own eggs who are aged 44 to 45 have less than a 5 percent chance of having a healthy baby even with the use of IVF. For women over 45, that rate essentially drops to 0 percent. These rates are primarily driven by a decrease in egg quality, meaning the percentage of eggs making chromosomal errors and thus not able to create healthy embryos moves closer to 100 percent as a woman reaches age 45. Moving on to egg donation at age 44 given these poor rates may be the best option for some women.
For women under 44, IVF provides an opportunity to retrieve multiple eggs during one menstrual cycle in order to find an egg that did not make a chromosomal error in development. It should be noted that IVF does not increase the quality of an egg but rather increases the odds of finding a good egg by collecting many eggs at one time. For women ages 38 to 43, only 10 to 20 percent of eggs are estimated to be normal.
One way to quantify whether it’s time to move to egg donation is to ask how many eggs have been given the opportunity to work. For example, a couple with a female partner age 40, who tried naturally for 1 year (1 egg per natural cycle), did 6 cycles of clomid and artificial insemination (2 eggs per clomid cycle) and then 3 cycles of IVF (8 retrieved eggs/cycle) exposed 48 eggs to pregnancy. Of those 48 eggs, 4-5 should have been normal.
Failure to have a healthy child in this example suggests that the quality of the eggs or the resulting embryos are abnormal, and the couple should move on to egg donation. For women who produce a low number of eggs or embryos, experience repetitive miscarriage, or consistently produce abnormal embryos from preimplantation genetic screening (PGS), an earlier move to egg donation may be warranted.
Using donor eggs to have a baby involves egg retrieval from a younger egg donor. The eggs are then fertilized with the woman’s partner’s sperm or that of a donor, and then implanted in her uterus. For more information on using donor eggs to achieve a pregnancy, please see this page.
Advice for Getting Pregnant After 40
Although we can provide you with advice about conceiving after 40, everyone’s situation is completely individual. If you have been trying to conceive without success, then the first thing you should do is to see a qualified fertility specialist, especially if you have been trying for six months or more.