You’ve seen the photos — Hollywood celebrities proudly sporting baby bumps well into their thirties and even their forties. Such images might lead you to believe that 40 is the new 20 when it comes to women’s fertility. But in reality, your biological clock marches on every time you blow out the candles on your birthday cake. “Women at 40 may look 20, but they still have 40-year-old eggs,” says William E. Gibbons, MD, director of the Family Fertility Program at Texas Children’s Pavilion for Women and director of the Division of Reproductive Endocrinology and Infertility at Baylor College of Medicine, both in Houston.
In older women, the issue with eggs is about both quantity and quality . Women are born with all the eggs they will ever have. At birth, you have more than a million, but by the time puberty rolls around, only about 300,000 remain. Of those, just a few hundred will mature and be ovulated during your reproductive years. The rest — about a thousand a month — are simply lost in a process called atresia.
The best genetically sound eggs ripen and are ovulated first. So, the cream of the crop is released during a woman’s younger years. Angela Chaudhari, MD, an obstetrician and gynecologist at Northwestern Memorial Hospital in Chicago, adds that as eggs age, they are more likely to have a mutation because of the aging process. In older women, these factors affect both the ability to get pregnant and the chance of miscarriage, which increases. Older moms are also more likely to give birth to babies with chromosomal issues, like Down syndrome.
Family Planning: Your Fertility Timeline
In women’s health, reproductive years officially begin at first menstruation and end at menopause. Dr. Gibbons says that, biologically speaking, the best time for a woman to try to conceive is between the ages of 18 and 30. The biological clock really starts ticking at age 32, when doctors can detect a decline in egg quality and, therefore, fertility, Gibbons says. Every year after 32, your chances of having a baby drop.
Here’s the fertility timeline as you move into your late thirties and forties, according to Gibbons:
- At age 35, one in five eggs in the ovary is genetically normal.
- At 40, one in nine is normal.
- At 45, the number drops to one in 15.
Delaying Motherhood and Infertility Treatments
Older women may not realize just how much their biological clock is working against them. “Too often women past the age of 40 have unrealistic expectations,” Gibbons says. “They believe that infertility treatments will be the solution.” A recent study by Yale University researchers bears that out. They found that more women age 43 and older are turning to infertility clinics under the misconception that pregnancy can be instantly achieved despite their age.
According to data from the U.S. Centers for Disease Control and Prevention, assisted reproductive techniques, like in vitro fertilization (IVF), resulted in a live birth for fewer than 7 percent of 43-year-old women who used their own eggs.
But getting pregnant using a donor egg can raise your chances significantly. “A 45-year-old will have the same pregnancy rate as a 25-year-old if she uses a 25 year-old egg,” Gibbons says.
Still, having a baby later in life can put you at greater risk for gestational diabetes, high blood pressure, and preeclampsia, Chaudhari says. “Older women in their first pregnancy seem to have a higher rate of cesarean section as well,” she adds.
If you’re prime-time baby-making age, but aren’t ready for motherhood, you do have options. One is to freeze eggs to use at a later time, a process called oocyte cryopreservation. It’s an expensive option, costing as much as $25,000, plus there’s a chance that your eggs will not survive the freezing, thawing, and fertilization process. Although still a relatively new procedure, freezing eggs is no longer considered experimental by the American Society for Reproductive Medicine and is expected to soon become mainstream. Still, timing is vital. “The earlier a woman chooses this option, the better chance of success,” Gibbons explains.
Another possibility is embryo freezing, which is also expensive but has a higher pregnancy success rate than freezing eggs, says Chaudhari. “This, of course, requires a sperm donor or partner, which some young women may find unacceptable,” she adds.
One Woman’s Journey to Motherhood
Robin Gorman Newman of Great Neck, N.Y., now 51, hit a few bumps on the road to motherhood. Newman, the founder of MotherhoodLater.com, and her husband struggled with fertility problems when they decided to start a family, when she was about 36 years old. Newman says both partners had infertility issues, but she believes her older age probably played a role. The couple decided to try IVF, but that didn’t work. “It was exhausting, and I was not comfortable with the whole process,” she says. “Ultimately, we pursued adoption.” Four long years after that decision, Newman and her husband finally became the proud adoptive parents of Seth, now 9 years old.
Newman says being older gives her vital life experience that she uses as a mother. “I try not to sweat the small stuff, and I trust my instincts as a parent. Age is an asset, not an issue,” she says. Newman adds that she does not regret not trying to have a baby earlier in life. “I believe in fate — you get the child you are meant to have. My son is a gem — I couldn’t love a child more.”