Understanding Fertility in Your Forties

Dr David Robertson, group medical director at Bourn Hall Clinic Dubai, explains fertility at forty.
Halle Berry
Halle Berry
Dr David Robertson FRCOG, 
Group Medical Director
Bourn Hall Clinic Dubai www.bournhall-clinic.com;
 800-IVF/+971 4 705 5055
Dr David Robertson FRCOG, Group Medical Director Bourn Hall Clinic Dubai www.bournhall-clinic.com; 800-IVF/+971 4 705 5055

We all know that, as a rule, women are having children later in life and for, many people, delaying parenthood makes sense for a variety of reasons. For those choosing to wait until their forties to start a family, it is certainly still possible to conceive but there is no denying that the chances of getting pregnant are a lot lower than in your twenties and thirties, plus there are other implications for the pregnancy that you should be aware of. The fact is fertility decreases with age and this process accelerates at a much faster rate the older you get. What many people don’t realise is that the chance of falling pregnant is only ever relatively low, even for younger women. A 25-year old woman has around a 25 per cent chance of conceiving during each cycle, providing they are having regular intercourse and there are no underlying medical factors. By age 35 this falls to around 12 per cent and by 40 women have only a 5 per cent chance of conceiving naturally.

Lifestyle certainly has an impact on fertility with poor diet, lack of exercise, obesity, high intake of alcohol and smoking all taking their toll; the older we get, the more marked the effect. As a woman nears the end of her reproductive cycle her number of eggs is significantly reduced making it harder to get pregnant and egg abnormalities also become a lot more apparent. An increase in chromosomal abnormalities increases the risk of miscarriage and birth defects such as Down’s syndrome, which is why these complications are more common in older women. About one in 200 babies born to women over 40 have Down’s syndrome compared to one in 700 with women 35 to 39 and one in 1,500 aged 20 to 24. Half of all pregnant women aged 42 suffer a miscarriage and this rises to three quarters for women aged 45 years or more. For these reasons older women are given extra care during pregnancy and you will receive additional support.

You should do everything you can to improve your lifestyle when you are trying to conceive and this is more important than ever in your forties. Limit alcohol intake to as little as possible, quit smoking and maintain a healthy weight to prepare your body as much as possible. I would always recommend that a woman of this age gets expert advice from a fertility professional at the start of the process so as not to waste any time. Hormone tests such as the Anti Mullerian Hormone (AMH) give an indication of a woman’s egg supply, which can help to predict the usefulness of fertility treatment. Over 40, the need for IVF treatment becomes a lot more likely and it will give you the best chance of pregnancy compared to any other method of treatment. It is important to remember, however, that many women over forty do have healthy pregnancies both naturally and via IVF, so making sure you are fully informed of your options will allow you to make the best possible decisions for you and your family.

INFO: Dr David Robertson FRCOG, Group Medical Director Bourn Hall Clinic Dubai www.bournhall-clinic.com; 800-IVF/+971 4 705 5055.

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