Fertility After 40 - Determining Pregnancy Chances

Determining Fertility In Your 40s

The American Society for Reproductive Medicine (ASRM) recommends that women over age 35 consult a fertility specialist after six months of regular, unprotected intercourse that does not result in a pregnancy. Infertility is technically defined as failure to conceive in 12 months, but since the fertility window for older women is smaller, we recommend consulting with a doctor about fertility in your 40s without waiting as long.

The ability of the ovaries to produce good-quality eggs (and ultimately good-quality embryos) declines with age, and practically all women by age 40 have lost enough of their ovarian reserve (OR) to qualify for a diagnosis of diminished ovarian reserve (DOR). At the Center for Human Reproduction, we consider all women above 40 to suffer from DOR and apply clinical protocols that individualize treatment to help women of advanced ages.

If you are exploring your fertility in your 40s but find yourself being treated the same way as the 25-year-old patient sitting next to you in the waiting room, we recommend that you reconsider your treatment plan. One of the many differences in treatment, for instance, is that older women require larger doses of fertility medications in order to produce enough good-quality eggs.

This does not mean that all women in their 40s have the same ovarian reserve, either. This is why CHR strongly emphasizes determining patients' fertility in their 40s before devising an individualized treatment plan.

CHR can diagnose DOR relatively easily with a few blood tests that measure follicle-stimulating hormone FSH, as well as anti-Müllerian hormone (AMH). High FSH levels and low AMH levels indicate DOR and the need for aggressive fertility treatment. Following diagnosis, we recommend that patients seeking pregnancy in their 40s proceed to treatment as quickly as possible to maximize their pregnancy chances, as ovarian reserve will continue to decline as time passes, making successful pregnancy more difficult.

Fertility in 40s: Better Outcomes the Sooner You Start

Egg Retrieval Over 40

Fertility potential at any age, particularly with fertility treatments, depends largely on how many eggs a woman can produce for egg retrieval, and how good the quality of those eggs are. Diminished ovarian reserve, which women over 40 almost always have, negatively affects both the quality and quantity of eggs and, ultimately, their fertility potential. As women “use up” the eggs they were born with, by age 40, many women deplete their ovarian reserve and have difficulty producing enough good-quality eggs to make it to implantation, even with stimulation.

However, there are plenty of fertility success stories over 40 with women who use their own eggs to get pregnant at CHR. Our individualized treatment protocols are suitable for each patient’s ovarian reserve status and are an important part of our patient’s' success. In recent years, CHR physicians pioneered the early retrieval or Highly Individualized Egg Retrieval (HIER) technique for women with DOR, which has also improved chances of fertility over 40, in some cases doubling the pregnancy rates with IVF.

Pregnancy at 50

Pregnancy at 50 is possible, but most women in their 50s require donor eggs to get pregnant. With HIER and individualized protocol, CHR’s fertility experts recently helped an almost 48-year-old patient conceive with her own eggs and deliver a healthy baby, demonstrating that pregnancy in women of very advanced maternal age is possible. As of 2019, she is the “oldest” patient ever reported in the literature to have delivered a healthy baby using her own eggs for IVF. However, we would advise a patient trying to get pregnant after 50 to consider donor eggs rather than their own eggs, as the chances of pregnancy with their own eggs would be minuscule.

Pregnancy over the age of 40 with the patient’s own eggs is very possible, especially in women in their early and mid-40s. CHR has some of the highest pregnancy rates, particularly for women over 40. We believe in giving the woman all the information she needs to make an informed decision about her personal pregnancy chances after 40 (or after 50). At the end of the day, the decision to pursue pregnancy in your forties (or later) and how you’ll try to achieve that pregnancy, is up to you, and we are here to help.