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Trying to conceive can feel overwhelming as is. But worrying about your age while TTC may make it feel even more overwhelming.
Here’s the reality though. Women 35 and older make up almost 19% of all pregnancies (and 11% of first pregnancies) in the U.S.
And this same trend is seen on a global scale too with women around the world having their first pregnancy at a later age.
So if you’re in your thirties, forties, or fifties and you have dreams of getting pregnant, you are nowhere near alone! But we know you likely have some worries. So keep reading to learn more about the risks as well as the benefits of trying to conceive after 35.
Key Takeaways
A geriatric pregnancy is one where the woman is over the age of 35. This is also referred to as advanced maternal age.
It’s true that increasing age affects fertility, especially after age 35. This is due to a natural decline in egg quality and changes in your menstrual cycle as you near perimenopause.
Pregnancies that happen after age 35 also bring a higher chance of complications. Some of the associated risks are gestational diabetes, preeclampsia, ectopic pregnancy, and genetic abnormalities. C-sections and preterm birth are also more likely as you age.
There are also some potential benefits to a geriatric pregnancy. These include improved cognitive and longer life span for the mother and improved social and emotional skills for the child.
If you’re 35 or older and you’re trying to conceive, there are a few things that can boost your fertility and prenatal care. Manage your health (especially chronic medical conditions), take prenatal vitamins, track your menstrual cycle, and get a preconception and prenatal screening. Make sure to also get adequate physical activity, sleep well, and manage your stress.
What Is a Geriatric Pregnancy?
The term “geriatric pregnancy” is an outdated term that people previously used to refer to a pregnancy in a woman aged 35 or older.
Nowadays, the more culturally acceptable term is “advanced maternal age.” But the concept is the same. A woman of advanced maternal age is 35 or older at the time of their estimated due date.
Why is age 35 the cutoff?
35 isn’t some random number that doctors threw out there one day. It’s actually based on research-backed evidence of a steady decline in fertility that begins around age 35. This decline also includes an increased risk of certain genetic disorders.
Other medical terms that are used to categorize pregnancies in aging women include:
- Very advanced maternal age (VAMA) – pregnancy in women above age 40
- Extremely advanced maternal age (EAMA) – pregnancy in women above age 45
In the next section, you’ll learn about how age plays a role in your fertility journey.
How Aging Affects Fertility?
Research shows that fertility declines with age.
According a 2020 study, here’s what a woman’s chances of conceiving within 12 months of trying look like:
Maternal age (years) | Chances of conceiving (%) |
<30 | 85 |
30 | 75 |
35 | 66 |
40 | 44 |
In the chart above, you’ll notice a fairly steady decline up through age 35 and then an even steeper decline between ages 35 and 40.
So what’s the culprit for this decline in fertility?
The main reason for this dropoff in female fertility has to do with how age affects the ovaries and eggs.
At birth, a female has a fixed number of ovarian follicles (which house the cells that mature into an egg). This fixed number ranges from 35,000 follicles to 2.5 million follicles.
The exact amount is heavily affected by genetics, and with each passing year, this number of ovarian follicles continues to reduce.
But there are other factors at play too. As with other bodily systems and functions, the quality of the ovarian follicles also declines over time. On top of that, a woman’s ovulation patterns can become more irregular and their uterine health declines.
All of this turns into a recipe for more potential complications with conceiving. That doesn’t mean you can’t get pregnant after age 35 though. More than likely, you can!
It also doesn’t mean you will absolutely experience challenges getting pregnant if you are over 35. It just means that there’s a higher chance.
Let’s say you do get pregnant after 35. Should you be worried about additional risks? More on this next!
How Does Age Affect Pregnancy?
All this talk may have you worrying: Is it risky to have a baby after 35?
Your overall health and genetics play a big role in any pregnancy risks that you face. But advanced maternal age can also be a factor in increased pregnancy complications too.
Below are some of the additional complications that could arise from getting pregnant over age 35:
Chromosomal abnormalities
As you age, you’re at a higher risk for having errors come up during the process of cell division.
To put this into perspective, women over age 40 account for 35% of all clinically recognized trisomies. For women in their mid-twenties, that percentage is closer to 2% to 3%.
(Trismomies are genetic disorders where there’s an extra copy of a certain chromosome. A well-known one is Trisomy 21, aka Down syndrome.)
Ectopic pregnancy
An ectopic pregnancy happens when the fertilized egg implants somewhere other than the uterus (like in a fallopian tube).
One study found that women older than 35 were eight times more likely to have an ectopic pregnancy than women between 15 and 19 years old.
There’s no one reason for this drastic increase in risk. It really boils down to the fact that as you age, you are more likely to accumulate risk factors of ectopic pregnancy, which include:
- Having multiple sexual partners
- Having had a pelvic infection
- Fallopian tube abnormalities
Gestational diabetes
As you get older, you are more prone to having a reduction in insulin sensitivity. Your pancreatic beta cell function is also likely to begin deteriorating.
This can lead to a higher chance of developing gestational diabetes during your pregnancy.
In the chart below (based on a CDC report), you can see how the gestational diabetes numbers compare for women in different age groupings.
Preeclampsia and hypertension (high blood pressure)
Geriatric pregnancy can put you at risk for preeclampsia and hypertension (conditions that involve high blood pressure). This is because when you age, your endothelium (the layer of cells that covers the inside of your blood vessels) is at a higher risk of damage. And endothelial damage negatively impacts your cardiovascular function.
One scientific review found that for women of advanced maternal age, the risk of developing preeclampsia increased by 1.2%. And for women of very advanced maternal age, it increased by 1.5%.
C-sections
One study of over 1.1 million births brought light to some important findings about C-sections:
- For women who had never birthed a baby before: C-section risk was twice as high (for women 35 – 39) and 3.6 times as high (for women aged 40)
- For women who had given birth before: the risk was twice as high (for women aged 40 or older)
There are a few possible reasons for the increased risk of delivering via C-section. These include:
- Labor dystocia (unusually slow or complicated labor)
- Decreased myometrial efficiency (when the uterus doesn’t contract effectively)
- Personal preference
Preterm birth
Preterm birth is when you go into labor before reaching 37 weeks of pregnancy. The odd thing about the risk for preterm labor is that it has a U-shaped correlation to age.
That means that preterm birth is more common among younger women (20 – 24) and women older than 40. Women between 25 and 40 seem to have less of a risk. Medical researchers are still trying to figure out why this unique correlation exists.
Low birth weight
A baby is considered small for their gestational age when their birth weight falls below the 10th percentile.
One study suggested a more pronounced correlation between small gestational age (SGA) and very advanced (>40) or extremely advanced maternal age. But the risk was less significant for advanced maternal age (35-40).
As of now, there’s no true agreement on why the risk of low birth weight increases with the mother’s age. But one theory is that it has to do with poor oxygen exchange between mother and baby.
As you can see, there are certainly some additional risks that can come along with getting pregnant further along in life.
Still, that doesn’t mean you will absolutely face complications. What’s more is that there are also some benefits to consider with having children in your mid-30s and beyond. Get ready to see some of these next!
What Are the Benefits of Having a Baby After 35?
There are a good number of upsides to having a baby after age 35.
Here are a few of the major benefits:
1. Lifespan
Some research shows that women who have babies in advancing age tend to live longer than those who have children earlier on.
In particular, one study revealed an interesting finding. In comparison to women who had their last child before 29, women who had a child after 33 were twice as likely to survive to an age in the top 5th percentile of other women born in their same birth cohort. Wild, right?
2. Cognitive function
Mothers who have their final child later on in life seem to have improved cognitive function markers. This includes having a better episodic memory and a more delayed onset of age-related disabilities.
3. Children’s health
Advanced maternal age may also benefit the child or children as well. One study found that for children up to age 5, having an older mother translated into improved health and development.
Some of these improvements included:
- Less hospital admissions
- Improved language ability
- Less difficulty with social and emotional markers
4. Financial security
Another potential benefit of getting pregnant later on is a higher likelihood of financial prosperity. For some older women, this may mean having a more established job or career and less stress over security.
While these benefits are inspiring, you may still be feeling overwhelmed about the first order of business: actually getting pregnant after age 35. So let’s wrap things up by going over where you should focus to give yourself the best chance at conceiving.
Tips for Getting Pregnant After 35
If you’re trying to conceive and you’re over 35, here are some ways to boost your health and fertility:
- Get a preconception check up and counseling from a trusted medical professional.
- Consider meeting with a fertility specialist who can more carefully look at your unique health and medical history.
- Begin a daily prenatal vitamin regimen (best to start this around 2-3 months before TTC). Talk to a healthcare provider, but usually 400 mcg of folic acid is recommended.
- Carefully track your menstrual cycle. As you age, you begin to experience hormonal changes and ovulation can become irregular. Inito can help you confirm when you ovulate so that you make every egg count.
- If you’re worried about chromosomal conditions, you can opt for prenatal genetic screening.
- Stay on top of your overall health and any conditions you have prior to pregnancy. This will help you maintain optimal health for both you and baby.
- Reflect on your lifestyle and adjust any areas where you can improve. This includes getting enough sleep, managing stress, eating well, and exercising regularly.
FAQs
The best way to naturally prepare your body for conception is to ensure you have a healthy lifestyle. This means getting good sleep, reducing your stress levels, eating a healthy diet, keeping a healthy weight, and exercising enough. On top of that, if you are ready to actively start TTC, you’ll want to start prenatal vitamins. One of the most important vitamins to get is folic acid. This is because it lowers the risk of neural tube defects.
Learn more: Vitamins for Fertility: Supplements to Take When TTC
There’s no specific age that makes you too old to have a baby. What determines how old you are able to be and still conceive is your menstrual cycle. If you are still ovulating, then you can get pregnant. Most women begin perimenopause during their mid-40s and then transition into menopause around 10 years later. But this is only an average. Some women start menopause much earlier or later than that.
No, for most women, 37 is not too late at all for having a baby. There’s a chance it could take longer to get pregnant, but it’s likely still possible. It all depends on your unique menstrual cycle and whether or not you’re still ovulating.
The best way to know if and when you are ovulating is to regularly track your menstrual cycles. Inito is a great tool for this as it can confirm when you ovulated!
You can still have a healthy pregnancy at 35 or older. But as you age, have an increased risk of:
- Gestational diabetes
- Preeclampsia or
- hypertension
- Ectopic pregnancy
- Having a c-section
- Preterm birth or low birth weight
- Chromosomal abnormalities
Yes, advanced maternal age is one risk factor that can make a pregnancy more complicated. But you can still have a completely healthy pregnancy. High risk simply means there’s an increased chance of complications.
Also keep in mind that there’s a spectrum to what’s considered “high risk.” Not all “high risk” pregnancies are equally complicated. Having certain pre-existing medical conditions or having a multiple pregnancy (like twins) can make a pregnancy high risk too.
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Pregnancy at Age 35 Years or Older | ACOG
Management of Pregnancy in Women of Advanced Maternal Age: Improving Outcomes for Mother and Baby
Knowledge about the impact of age on fertility: a brief review – PMC
Age-Related Fertility Decline – StatPearls – NCBI Bookshelf
The updated understanding of advanced maternal age – ScienceDirect
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