Am I too old to have a baby?

That broody feeling can strike at any age and we all know our fertility doesn’t last forever. If you’ve waited until later in life before deciding to try for a baby you may be wondering if you have left it too late.

Why does age matter?

It can be intimidating when a pregnancy after the age 35 automatically puts you in the “advanced maternal age” category but, it’s important to remember that pregnancy after 35 is still common.

We’ve all heard about the biological clock; that pressure to have a baby when you’re in your prime. Your biological clock starts when you get your first period and ends when you enter the menopause.

It may come as a surprise that your peak reproductive years are actually between your late teens and late twenties (1). 

As you get older, it can take longer to become pregnant and you are more likely to need medical help with getting pregnant. This is because the eggs in your ovaries are also getting older, causing a change in your fertility. 

You are born with a finite number of eggs, and over time this number, along with the quality of the eggs, decreases (2). According to the British Fertility Society, with each monthly cycle the chance of a successful conception is nearly 20% in women aged 30 or less and this drops to 5% in women by the time they turn 40 (3).

These statistics can be scary, especially if this is your reality. It’s important to remember that although fertility does change as you age, the changes are gradual — pregnancy doesn’t become impossible overnight!

What other factors influence your fertility?

There are many factors that influence your fertility that are unrelated to age; some you can even do something about!

• Smoking – if you smoke it is likely to take you longer to get pregnant than a non-smoker, with the chances cut by almost half every month (4). If you do smoke, the best thing you can do before getting pregnant is stop smoking.

• Alcohol – drinking alcohol is linked to fertility problems in both men and women. If you drink a lot and often, you may find it more difficult to get pregnant. Heavy drinking can also contribute to problems with your period, such as heavy, irregular or no periods. This means you are less likely to release an egg from your ovaries, which is needed for pregnancy. If you are planning a pregnancy, it is advisable not to drink alcohol during this time. (5)

• How close you are to the menopause – your fertility will usually start to decline 5-10 years before the menopause. The majority of women experience menopause between the ages of 45 and 55 years. When your body goes through the menopause is influenced by a lot of different factors including your family history, when your first period started and the number of times you have been pregnant.

• Sexually transmitted infections  – chlamydia and gonorrhoea are two of the most common sexually transmitted infections. Many people with chlamydia and gonorrhoea don’t have any symptoms at all. Both can lead to reduced fertility in men and women if they are not treated. If you think you or your partner might be at risk of a sexually transmitted infection it’s important to go for a check-up at a sexual health clinic before you start to think about starting a family. 

IVF and your age

Fertility treatments such as IVF can help you conceive. IVF is less successful as you get older because, unless you use donor eggs, the quality of your eggs decreases (6).  If you do have IVF, the team overseeing your care will be able to discuss your likelihood of success in relation to your age.

NICE is the body that makes recommendations to your local NHS Trust about what treatment it should offer (7). Some areas in the UK will only offer free NHS treatment before you have reached a certain age.

According to NICE, women under 40 should be offered 3 cycles of IVF treatment free of charge on the NHS if:

For women aged 40 to 42,  the NICE guidelines also says you should be offered 1 cycle of IVF free of charge on the NHS if:

However, the NHS trusts that run your local health services do not all offer the amount of IVF cycles described above. Some trusts may also apply other criteria, such as:

Your GP will be aware of the criteria for NHS-funded IVF treatment in your area.

Here is more information about what might happen when you go for an appointment at the fertility clinic. There are several different treatments you may be offered, and your clinic can advise more about what is best for you.

Age and male fertility

Men’s ability to have a baby also declines with age, although the decline is slower in comparison to females. If you and your male partner are both over 40, it can be harder to conceive.There are other reasons why having an older male partner might make it more difficult to get pregnant include (8):

• less interest in sex
• reduced sperm quality
• lower levels of male sex hormones

What if you aren’t ready to try for a pregnancy just yet?

Knowing that age has a significant impact on your fertility means that you can explore your options. Whilst the best thing would be to start trying to conceive earlier than later, this isn’t always possible. One option to consider is whether you should freeze your eggs.

Modern medicine has made some truly remarkable leaps in recent years, many of which are required to keep pace with our changing society.

There are many reasons women may look into freezing their eggs, and these may include:
🍳Those facing infertility for medical reasons such as chemotherapy for cancers
🍳Social reasons such as not having met the right partner and wishing to delay pregnancy until later life.

Egg freezing is a procedure to preserve a woman’s eggs by extracting them, freezing and storing. The woman may later choose to have the eggs thawed, fertilised via IVF and transferred to the uterus as an embryo to enable a pregnancy.
When done for social reasons, it can be argued that this process extends the window of opportunity for single women to find the right partner and offers hope when fertility declines with age.

However, it is important to note that the procedure can be expected to cost around £15k total, as well as a cost of storage and future fertility treatment. And of course, there is no guarantee of success. Evidence suggests the best time to freeze eggs is in the woman’s 20s, and definitely before age 37.

Can age affect my pregnancy?

When you google search the topic, the information can be overwhelming. However, if you’re planning a pregnancy and over the age of 35, it’s important to be informed about the increased risks for you and your baby which include:

Will my age affect my antenatal care?

If you are over 40 your midwife, GP, obstetrician or specialist teams may all be involved in your care during your pregnancy.

In order to make sure you and your baby are healthy, you will be offered extra scans, tests, and your blood pressure may be checked more often.  This is because of the higher risk of complications we discussed in the last section of the blog.

At your booking appointment, your midwife will explain your care plan in full. During this time, you’ll also be able to ask any questions and talk about any concerns you have.

It’s really important that you attend all your antenatal care appointments so your team can pick up any problems early and treat them.

What can you do?

If your age is something that is worrying you about trying for a baby, there are other steps you can take to try and prepare your body for pregnancy:-

We know the evidence tells us that age does matter when having a baby and it is important to understand and consider the risks involved in having a baby later in life. However, deciding to have a baby is a hugely personal decision regardless of what age you are when you make it.

It’s not as straightforward as only taking your age into consideration; everybody has different circumstances and your age is just one factor that is outside of your control. The most important thing to remember when reading statistics around having a baby later in life is that they are averages and can be used to set your expectations. However, there are no hard and fast lines.

The journey towards pregnancy can be harder for some women after a certain age and although some labour and birth complications are more common in older mums, this doesn’t necessarily mean that they will happen to you. If you haven’t conceived after 1 year of trying for a baby or within 6 months if you don’t have regular periods, talk with your GP who can investigate this further

References 

1.    Trawick E, Pecoriello J, Quinn G, Goldman KN. Guidelines informing counseling on female age-related fertility decline: a systematic review. J Assist Reprod Genet. 2021;38(1).

2.    Female age-related fertility decline. Fertil Steril. 2014;101(3).

3.    Society BF. Age and Fertility. 2016.

4.    Association BM. Smoking and reproductive life; The impact of smoking on sexual, reproductive and child health [Internet]. [cited 2021 Oct 3]. Available from: https://www.rauchfrei-info.de/fileadmin/main/data/Dokumente/Smoking_ReproductiveLife.pdf

5.    Fan D, Liu L, Xia Q, Wang W, Wu S, Tian G, et al. Female alcohol consumption and fecundability: A systematic review and dose-response meta-analysis. Sci Rep. 2017;7(1).

6.    Consensus views arising from the 56th study group: Reproductive ageing. In: Reproductive Ageing. 2009.

7.    NICE. Fertility problems: assessment and treatment. Natl Inst Heal Care Excell Guidel. 2013;(February 2013).

8.    Kumar N, Singh A. Trends of male factor infertility, an important cause of infertility: A review of literature. Vol. 8, Journal of Human Reproductive Sciences. 2015.

9.    Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: Prospective register based study. BMJ. 2019;364.

10.  Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017;12(10).

11.  Bayrampour H, Heaman M. Advanced maternal age and the risk of cesarean birth: A systematic review. Birth. 2010;37(3).

12.  Hassold T, Hunt P. Maternal age and chromosomally abnormal pregnancies: What we know and what we wish we knew. Vol. 21, Current Opinion in Pediatrics. 2009.