Why It’s Not So Rare to Get Pregnant after 45

Hope for Older Women Trying for Healthy Babies

Current conversations about fertility are failing the millions of women around the world who are 40 or over and trying to get pregnant. When we talk about when women should get serious about trying to conceive or of how much fertility declines with age, we talk past a huge community of women who are hoping to become mothers after age 40.

I remember the recurrent sorrow and crazy-making frustration of trying to get pregnant, starting when I was first ready to become a mother—not until I was 41—and lasting until I was lucky enough to conceive my first child at age 45. She was born when I was 46 and she is, I’m incredibly grateful to report, now a healthy, happy 3 and a half year old. I also remember how unhelpful much of the discussion around fertility and age was, during those years when I was trying and failing to get pregnant or to carry a pregnancy to term.

Because here’s the thing: Women like these, and like I once was, are not in the position of deciding when to have a baby or whether they should try before reaching “advanced” or “very advanced maternal age.” The ship has sailed on that one. The reality is, they are already in their 40s. And the teeth-aching desire to meet and hold their baby has not declined with age.

But I’ve realized recently that, surprisingly, the most relevant—and it turns out, most hopeful—information for my fellow 40+ year olds isn’t even found where people tend to look during discussions of fertility. Instead of focusing on studies comparing fertility at various ages or surveys of ART successes and failures, we should look to US census data on births and, perhaps paradoxically, to statistics on abortion, menopause, and sterility.

To be clear: I’m not arguing women should wait. I’m not arguing they shouldn’t. I’m saying, is that if a woman happens to be in her 40s and trying to conceive, she should know there actually is some hope, tempered though it may be. The chances are certainly smaller than when she was 25, and even 35. But that’s immaterial now. And it doesn’t by any stretch mean there is no chance. This point bears stressing and examining in the absence of comparisons with younger women.

Besides having given birth to a healthy baby conceive naturally when I was 45, I’ve also been unusually lucky to have heard from over 500 women, aged 40+ who are trying to conceive or who are already pregnant and who have found me through this blog and  left comments here or contacted me directly. I love hearing from all of you and am grateful to be privy to some of the uncensored thoughts, concerns, questions, and emotions being shared among this population.

Especially for those women 42 and older who get in touch, I hear frequently that they’ve either heard or just feel they have “no chance,” a “0%” likelihood of becoming mothers with their own eggs. A significant number also tell me they feel ashamed, have been told they’re “crazy” for thinking they might have a shot. These are the women I’m writing this for now. (And you go, ladies, for trying!)

Overlooked Stats Show Hope for Women 40+

Census statistics on live births & medical abortions

https://www.cdc.gov/nchs/data/vsrr/report002.pdf: According to the Center for Disease Control and Prevention, in 2016, there were 111,848 births, (1.1% of population) to women 40-44. This covers all births, not just births to women who were trying to conceive, suggesting that if all 40-44 year olds in 2016 tried to conceive every month, the percentage of women in this age group who’d had babies would be considerably higher. To women between 45-54 (with the great majority falling between 45-49), 9,025 babies were born.

Combining these stats with those on abortion in 2015 for the 40-44 age group, (20,962)–the latest age group and last year in which statistics were collected–and then dividing this number by 3 (accounting for expected 33% miscarriage rate in this age group), we could expect to add around 7,000 babies, totaling close to 120,000 births. This number would actually be a low estimate, since many miscarriages occur before scheduled abortion dates.

All together, we could expect between 125,000-130,000 live births in 2016 to women 40-49. Put into context, that’s a population of babies likely greater than the total population of most of our hometowns.

Perhaps most significantly, these statistics hold steady or decline only somewhat when viewing births before egg donation was available in the US (See births 1933-1998 @ https://www.cdc.gov/nchs/data/natality/mage33tr.pdf.)

Sterility & menopause

https://www.ncbi.nlm.nih.gov/pubmed/12268772: According to a review of the literature pertaining to declining fertility with age, the likelihood of permanent sterility at age 40 is about 40% and at age 45 is about 80%, meaning one of out every five 45 year olds should be able to become pregnant at some point during their 45th year.

http://www.healthline.com/health/menopause/pregnancy#1: As explained by executive director emeritus of the North American Menopause Society Dr. Marjory Gass, pregnancy even in the mid-to-late 40s is not impossible for most women. “Never assume, ‘Oh, I’m too old to get pregnant,’” Gass has said. “Unless you have gone a year without a period–the technical definition of menopause—pregnancy remains a possibility.”

Birth defects & miscarriage

I get a lot of questions over email and on this blog about whether getting pregnant in the 40s, especially in the mid-40s, guarantees a miscarriage or a child with a genetic abnormality. Many women, myself included, field questions from family members about whether it’s even wise to get pregnant or hope for a positive outcome given the dire statistics on Downs, etc., for older mothers.

When viewed from the perspective of high the risks are compared to pregnancy at 25, the numbers do look grim. But when viewed from the perspective solely of the chances for a healthy baby at various ages throughout the 40s, the numbers are much more hopeful (and again, relevant):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071156/: “For women at 42 years of age, more than half of the intended pregnancies (54.5%) resulted in fetal loss…The risk of spontaneous abortion [was] 84.1% by the age of 48 years or older.” So yes, these are scary statistics, and they aren’t great, but they are better than many people fear and assume, especially if we look at them in reverse, from the perspective of a positive outcome rather than negative: a 45% chance of success for a 42-year old to carry a pregnancy to term, and even a 15% chance of success for a 48-year old.

https://www.ncbi.nlm.nih.gov/pubmed/6455611 & https://embryology.med.unsw.edu.au/embryology/index.php/Genetic_risk_maternal_age : The estimated rate of all clinically significant cytogenetic abnormalities at age 40 is 15.8 per 1000, meaning we can expect between 98-99% of all babies will be born genetically healthy. For age 45, it’s 53.7 per 1000, or between 94-95% of babies. Even for women giving birth at 49, only 12.5% of babies will carry a genetic abnormality, meaning 87 out of every hundred babies will be born genetically average.

So if you’re out there now and are trying to conceive in your 40s, please know that I’ll be keeping you in my thoughts and hoping you have the same good luck I—and almost 9,000 other women aged 45-49 in the U.S. last year—had. And please know that I and thousands of other women are out there, pulling for you.

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see An Honest Take at Getting Pregnant Naturally at 45Getting Through to Getting Pregnant at 45 and On Delivering My First Child at 46, other blog posts I wrote in the hopes of supporting people slogging through infertility, although some of the content from these is reproduced in this post. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Postonline and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used. In any case, I will continue to keep you all in my thoughts. Finally, if you’re *still* interested in my story [bless you for your patience if so!], the story of how I met and fell in love with my husband–a bit late in life– and then went through years of IVF and finally got pregnant naturally, is in my book The Good Shufu.)

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10 thoughts on “Why It’s Not So Rare to Get Pregnant after 45

  1. Thank you,
    I am in my late 30’s, have been presented with obstacles and setbacks, you could say I got a late start to life. I feel stress, pressure and worry, even fear when thinking about if I will get the opportunity to have a child. Your story, positive outlook on the information given and interpretation of the state give me some calm, confidance and for that I am so grateful.

    With Gratitude

    Like

    1. Hi Melanie. Thanks for leaving your comment. It sounds like you have been through so much. I remember how hard the years were when I was trying to get pregnant in my 40s, and I’m sorry you are struggling with this now too. But I’m keeping everything crossed that you have the same good luck I did. In the meantime, please know that I’ll be keeping you in my thoughts, too. All my best,

      Tracy

      Like

  2. i want you to know the fertility clinics will lie to you as well. I was 42 when I decided to marry and have a child. I made sure to ask my future husband if he wanted children and to have him checked out. he insisted he was fine, so did the fertility clinic. I was told in no uncertain terms that I would never have a child. heartbroken , if found out later, my husbands sperm count was only 50 million, 85 percent malformed, he never told me. neither did the clinic. my chances were stolen from me, when I reported this to the college of physicians and surgeons, they just supported the clinic. some lies, are just cruel, and you cannot forget them.

    Liked by 1 person

    1. Hi Sandra. Thanks for your comment and for sharing your experiences. I’m so sorry to hear you had such a terrible experience with your clinic and with your husband. I’ll be keeping you in my thoughts and hoping that your next dreams come true. With all my very best wishes,

      Tracy

      Like

      1. Thanks for such positivity.. my story is far from it.. started trying at 41 (I have 2 older kids) and 2 miscarriages later finally successful pregnancy at 44. Unfortunately ended by abortion at 16weeks due to positive test for T21… now 45 I am still dreaming. ..I have not been the same since, but trying to slow recover mentally and still hoping.

        Liked by 1 person

      2. Hi Tamara,

        I’m so sorry to hear of your losses. It sounds so devastating. Please know that I’ll be keeping you in my thoughts and my heart, and wishing you a peaceful recovery, as well as all the luck in the world with your continued hopes.

        With my warmest and best wishes,

        Tracy

        Like

  3. I can say that I’m not trying to conceive at 46 but we aren’t taking precautions. He’s 53 and does not want any more children, especially because he has grandchildren.

    I feel that if I do get pregnant, the baby is a gift. I would certainly welcome another child into my family.

    I hope those parents who want to conceive can do so. Statistics are just that, statistics.

    I believe parenting at this age could certainly be very fulfilling and maybe even exhausting. Beware of people who make negative comments, I believe that secretly some couples would love to conceive and have another child in their forties. of course, adding a baby into an empty nest may not be a shared idea.

    I wish all parents who want to conceive later in life have the chance to do so.

    Emmy

    Like

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