Pregnancy Risk at very Advanced Age (over 40)

It has become more common for women over 40 to seek fertility treatment but the risks associated with pregnancy in the fifth decade of life should be understood.

Fertility dramatically declines after age 40, and aging eggs are more likely to carry genetic abnormalities. The health risk to both mother and fetus is increased, and pregnancy complications are more likely.

 

MATERNAL AND FETAL RISK IN PREGNANCY AT AN ADVANCED AGE

Genetic abnormalities in the eggs of mothers of advanced age can interfere with implantation and also mean older women are more likely to miscarry or deliver a baby with a birth defect.

The odds of a mother over 40 giving birth to a child with chromosomal abnormalities also significantlyincreases. At age 35, the risk of having a baby with chromosomal abnormalities is 1/192, but by age 40, the risk climbs to 1/66 (almost 2%).

Women of advanced age who are overweight or have health conditions, even very mild or early indications of high blood pressure, diabetes or elevated cholesterol levels, may suffer serious pregnancy complications.

During pregnancy, older women are more likely to develop preeclampsia, a pregnancy condition characterized by high blood pressure and protein in the urine, as well as gestational diabetes.They may also experience problems with the placenta and are at a higher risk of ectopic pregnancy or cesarean delivery.The risk of stillborn birth climbs after the 40-week gestation mark in moms of advanced age, so C-section is typically scheduled at that point if delivery has not already occurred.

 

FERTILITY TREATMENT OPTIONS FOR WOMEN OF ADVANCED AGE

Women who are concerned about the risks or who have difficulty becoming pregnant, do have options.Egg donation, the use of eggs from a younger woman in her 20s or 30s, can be the answer in some cases. Donor egg IVF allows an older mother to carry and deliver a baby while increasing the chances for a healthy pregnancy.

Women over 40 may also want to explore the possibility of surrogacy, a process where another woman uses her egg and the male partner’s sperm to become pregnant allowing the couple to produce a child that is genetically related to one parent. The surrogate may be a family member, friend or someone selected through a specific program.

Our reproductive endocrinologists are happy to discuss the fertility options available to women of advanced age who are hoping for a baby

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