July 2022

Print this issue

Having Kids Later in Life

Healthy Pregnancies as You Age

There are many reasons you might wait to have kids. You may want to focus on your career. Or save some money first. About 20% of women in the U.S. now have their first child after age 35.

You may have heard that getting pregnant can be more difficult as you age. Or that it’s riskier for both the mom’s and the baby’s health. While these can be issues when having children later in life, many concerns are manageable.

Getting Pregnant

It can be more difficult to get pregnant with age. There are many reasons for that. One is that fertility decreases as you get older—for both men and women.

Women are born with a set number of eggs. Each month, a woman’s ovary releases an egg to be fertilized. This process is called ovulation. But before that, her body recruits many eggs in preparation for this process. A handful of eggs are developed and matured, but usually only one makes it to ovulation.

“As women age, they’re still fertile, but their odds of pregnancy are decreased because they’re not making as many good eggs that will fertilize and divide normally and turn out to be an embryo,” explains Dr. Alan Decherney, an NIH fertility expert.

After age 30, a woman’s fertility decreases every year. The number and quality of her eggs goes down until she reaches menopause. Menopause usually happens around age 45 to 55. During that time, women stop having their periods and are no longer fertile.

Older men may make fewer sperm or lower-quality sperm. The age-related decline in egg and sperm quality is associated with a higher chance of the child developing certain health conditions. This includes autism spectrum disorder, Down syndrome, and schizophrenia.

But most healthy women who give birth in their 30s and 40s have healthy babies.

Pregnancy Problems

If you’re over 35 and haven’t gotten pregnant after trying for six months, talk with your health care provider. You may be experiencing issues with infertility. Infertility is when a couple can’t get pregnant or a woman hasn’t been able to carry a pregnancy to term.

NIH-funded researchers are studying the causes of infertility for both men and women. There are many reasons for infertility.

“The most common cause of infertility in women is related to ovulation abnormalities,” says Dr. Esther Eisenberg, who oversees reproductive medicine and infertility research at NIH.

Many factors influence your ovulation cycle. Being older is one of them. You may not ovulate regularly, or sometimes not at all.

Another cause of infertility is endometriosis. This is a disease in which tissue normally found in the uterus (womb) grows outside it. Endometriosis can cause painful periods, urination, or bowel movements. It accounts for at least a third of infertility in women. It’s more common for women in their 30s and 40s.

Fibroids are also more likely as you age. These are abnormal growths made from the uterus’s muscle cells. They can grow inside or outside of the wall of the uterus. These growths can prevent a woman from getting pregnant. Most women get at least one fibroid in their lifetime. But they’re most common between the ages of 40 to 50.

Other causes of infertility can be treatments for certain health conditions. “Women who have been treated for cancer might have a reduced number of eggs,” Eisenberg says. “If you’ve had other conditions that require surgery to remove an ovary or fibroids—in which you’ve had surgery on the uterus—that might impact your fertility as well.”

Seeking Help

“If being able to have a child becomes an issue, there are treatments,” Eisenberg says. “The majority of women are able to have a child with help.”

Treatments for infertility depend on the cause. Endometriosis and fibroids can be treated with drugs, surgery, and other methods. Medicines can help stimulate ovulation. These are called fertility drugs. Some are taken orally and others are injected.

Other options may be assisted reproductive technologies. Examples include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). These procedures help you get pregnant using different methods of fertilizing an egg.

Decherney’s group studies egg preservation, which involves freezing eggs. It may help some women facing health conditions that can reduce fertility. “But it’s expensive,” he notes.

Staying Healthy

Infertility isn’t the only issue older couples face. “Whether a woman can have a baby as she ages also depends on her health,” Decherney says. “The chances of having diabetes or high blood pressure—which are the two major diseases that impact pregnancy—are higher.”

Obesity, heart conditions, and cancer can also interfere with a woman’s ability to get pregnant or stay pregnant. They can lower men’s fertility, too.

Talk with your health care provider before becoming pregnant. They can help you plan for a safer pregnancy.

Being older when you’re pregnant also makes you more likely to experience health problems from being pregnant or giving birth. These include heart disease, infection, bleeding, high blood pressure, and blood clots.

High blood pressure puts pregnant women at higher risk for preeclampsia. Preeclampsia is a serious medical condition that can cause you to go into labor early. It can also lead to death.

No matter your age, you have a better chance of getting and staying pregnant by living a healthy lifestyle. See the Wise Choices box for tips.