Can I Get Pregnant After 35? A Candid Consult

Now more than ever, women are choosing to have children later in life. There are a variety of personal reasons for why women may choose to delay having children – whether related to career, financial, or relationship plans. Yet, despite pregnancy after age 35 becoming more common, there still is stigma around it.

In this edition of Candid Consult, Dr. Samantha Seidor OB/GYN, shares her own personal perspective and offers advice for others on how to plan for a healthy pregnancy after 35.

1. Is it possible to get pregnant after 35?

It’s definitely possible to get pregnant after 35! At nearly 40 years old, I am the proud mother of a beautiful 2-year-old girl, and I am happy to announce that I am due with my second baby girl on Mother’s Day 2024. Like countless other women, I prioritized my career and sought to find the perfect partner before embarking on the journey of motherhood, a choice that ultimately placed me in the category of advanced maternal age for all my pregnancies. In recent years, there has been a noteworthy surge in the number of women in the United States choosing to have their first births after the age of 35. It’s crucial to approach pregnancies during this stage of life with a thorough understanding of the potential risks and proactive strategies to address them.

2. Why is a pregnancy after age 35 labeled a “geriatric pregnancy”?

“Geriatric pregnancy” is a phrase that was historically used to refer to pregnant women over 35. Now, the correct medical terminology is “advanced maternal age.” This phrase may sound harsh, but we differentiate pregnancies in women older than 35 because, at this age, fertility declines more rapidly, and the chances for pregnancy-related complications increase. Again, it is very possible to have a healthy pregnancy over the age of 35, but it is also important to understand the associated risks and know when to reach out to your OB/GYN.

3. Is it true that fertility decreases with age?

Yes, according to the American College of Obstetricians and Gynecologists (ACOG), the pregnancy rate for healthy women in their 20s is 25% per menstrual cycle. This rate drops to 10% for women in their 40s . As we age, our egg quality and quantity declines, sexual activity decreases, and the risk of conditions that adversely affect fertility increases (these conditions include fibroids, endometriosis, and early menopause).

If you are over 35 years old and having trouble conceiving naturally after 6 months of timed intercourse, we recommend reaching out to your Axia Women’s Health OB/GYN provider for an evaluation.

During an evaluation, we may recommend treatment with medication to increase your chances of pregnancy or a referral to one of our fertility partners to explore assisted reproductive technologies like Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF).

4. Are there certain risks associated with pregnancy as you age?

Women over 35 face heightened risks during pregnancy, including fetal chromosomal abnormalities (such as Down Syndrome). To mitigate this risk, genetic screening (noninvasive prenatal testing or NIPT) and diagnostic testing (amniocentesis and chorionic villous sampling) are offered early in pregnancy.

Older women tend to have more medical problems than younger women (diabetes, and hypertension) which can pose significant risks to both maternal and fetal health throughout pregnancy. Additionally, older mothers are also more prone to developing pregnancy-related complications such as gestational diabetes and pre-eclampsia.

For women over 35 contemplating pregnancy, it’s crucial to engage with healthcare providers prior to conception. During these consultations, we review existing medical conditions, current medications, and individual risk factors, crafting a tailored plan to optimize maternal health and foster a healthy pregnancy journey.

5. How much of a role does lifestyle play in having a healthy pregnancy later in life?

Lifestyle can greatly influence overall health and well-being, as well as fertility. When trying to become pregnant, it is important to ensure you are eating healthily, exercising, reducing stress (when possible), and eliminating harmful environmental exposures.

Smoking, alcohol, the use of illicit substances, and even some prescription medications can all negatively impact fertility and pregnancy. It is important to review all aspects of lifestyle with your clinician when attempting pregnancy.

6. What types of things can I do before pregnancy to ensure I’m entering it healthy?

I always encourage women to come for pre-conceptual counseling prior to pregnancy. During this visit, we perform a full physical exam and lab work. We review your lifestyle habits, pre-existing health conditions/medications, test for insulin resistance, thyroid disease, as well as other medical conditions. We ensure you have been offered all appropriate immunizations before pregnancy. We also offer genetic testing and counseling to determine if you could potentially pass on recessive diseases like cystic fibrosis or spinal muscular atrophy to your baby.

Pre-conception planning is key to a healthy pregnancy. The more we know about your health before you enter pregnancy, the better we can assist in helping you throughout your pregnancy journey.

7. When should I start talking about reproductive planning with my doctor?

It’s never too early to have a discussion with your provider and explore your options!

Fortunately, these days thanks to advances in medicine, there are so many ways to build a family. If you’re entering your mid-30s and having kids is more of a long-term goal, you may want to explore fertility preservation options like egg freezing or embryo banking. Research shows that women who freeze their eggs before age 35 have the most success with a live birth.

Our mid-30s can be a wonderful time in life as we have more stability in our careers, personal lives, and a better awareness of our overall health. With proper planning and discussions with your provider, you can achieve a healthy pregnancy after age 35.