How Old Is Too Old To Get Pregnant?
How old is too old to have a baby? Eggs and embryo freezing is not the only option. There are several methods to increase your chances of getting pregnant.
To start with, no matter your age, it's really important to get your T.U.S.H.Y. checked.
- Tubes checked
- Your genetic profile
So how does this relate to age? How do you know if your eggs are too old?
FSH, estradiol and AMH
FSH and estradiol are two hormones.
- The FSH is secreted by the brain
- The estrogen is secreted by your ovaries
When we get these levels checked, we do them around cycle day number 3. They give us an idea about how hard your brain is working to talk to your ovaries.
Then we have the AMH level.
- The AMH is the anti-mullerian hormone which is secreted by cells that are surrounding the eggs.
The more eggs you have, the higher the AMH. When you get older, the lower the AMH means the lower the egg count.
AMH also stands for "Always Mean Hormone" or "Always Meandering Hormone". What I mean by that, is these things go up and down over time. They can slowly go up, slowly go down. I have patients say to me "my AMH went up, it's higher than it was 3 years ago" and I say you know it's just about the same! Those kind of fluctuations are normal.
Ultrasound of your ovaries
Then we have an ultrasound of your ovaries and that's where the AFC comes in. We count the little black circles, also known as follicles, they each carry eggs inside.
That number means a lot to me. I take all that information together and no matter what the level is, even if it's on the lower side, it never means no.
So you take your age, these hormone levels, and you get a really good idea about what your pregnancy chances are.
for example, if you're over 40, that age is more important than any of these levels. Each egg for a woman over 40 has about a 10% chance of being genetically normal. So what I tell my patients who are over 40 is this:
Have a threshold, give it a length of time of trying, and say after six months let's reevaluate. Let's see what's going on, repeat these levels, get a better understanding of what you've been through for the past six months.
And only then start talking about other options. Because I certainly want my patients to be moving on with the next stage of their life.
I want to help them reach their goals right away. But I know for some people it can take 13 years, literally. Everyone's journey is not the way they initially envisioned in the very beginning but it's really important to go through the right steps and every negative test to me, means one step closer to a positive.
Chronological age versus vs biological age
You can look amazing on the outside, you know you might be 40 but you've taken such good care of yourself that you might think that you're 28 - biologically.
But the thing is that your fertility isn't skin deep. Your eggs don't know how amazing you look on the outside. If you're 40 your eggs are still 40 on the inside.
I wish that I had a tool that I could use to help women grow more eggs once they've run out.
I have patients that come to me and say "I want to do IVF, I'm 46 years old, I'm ready to have a baby. But it has to do with my own egg". I say to them that we're going to go into this expecting that it's not gonna work. But I think it's so important that a woman given an option to use her own eggs if she wants.
Because a man can have a pregnancy basically as long as he is producing sperm, no matter the age. So who am I to limit a woman's chances?
Going through the process of going through an IVF cycle, even if we don't make it to an egg retrieval is always worth it for me. Because then that patient of mine will learn more about her biology than she ever has before.
But at least attempting the process of IVF or taking fertility drugs gives her an opportunity to say: "I don't know this is worth it for me to go all the way through an IVF cycle but yes, I still really want a baby and I think now I'm ready to consider donated eggs".
Certainly it's extremely important to be very healthy. However, when it comes to our ovaries, you can't put Botox in your ovaries! You constantly hear me say your fertility isn't skin deep. So take advantage of your fertility no matter what your body size is. But at the end of the day, if you're 40, your ovaries are still going to be acting 40. No matter what your biological age tell age tells you.
Tips to increase your chances of getting pregnant
Here are some tips no matter what how old you are for giving yourself the best chance of a healthy pregnancy:
- Exercising: Being in great shape and being physically fit is super important. The reason is not just for baby's health but also for your recovery postpartum.
- Eating healthy: This is very important. Eating green leafy vegetables and following a Mediterranean type diet. It has been shown to be very beneficial from a fertility standpoint.
- Supplements: I recommend to my patients Coq10 until you're done having your babies. Prenatal vitamins, fertility teas and folic acid will be very helpful. Also, getting checked isn't just checking your fertility hormones but also checking things like thyroid and vitamin D. If your vitamin D is low, I'll add on vitamin D to this list of supplements that I ask my patients to take.
Pregnancy over 45
If you're 45 and you want to have a baby, you obviously think that you are ready and you're strong enough to do so. I will empower my patients with the information they need to give themselves the best chance of a healthy pregnancy. But I'll also make sure that they know that having a pregnancy over 45 isn't risk-free. Having a pregnancy over 50 isn't risk-free either.
Cholesterol, Mammogram, Cardiac Stress Test and Diabetes Screen
The things that we do are: look at cholesterol, diabetes, cardiac stress tests, mammogram. Certainly, there are other tests that your doctor might want to do for you. But making sure that you're in great physical health and won't have the pregnancy complications or you won't be at high risk for the complications that risk that we worry about - for example, preeclampsia and any cardiac events - is super key before you move forward into a pregnancy.
But at the end of the day, no matter how healthy you are, your age alone might increase your risk of having problems in pregnancy. So having a specialist that will be on hand to guide you through this process who feels very confident in your ability to have a baby that is very important.
Menopause and pregnancy
What?! How can you be pregnant and have menopause? How does that make sense? Well, guess what? You can. You just need a healthy uterus to have a baby. One day they're gonna be men running around everywhere with a healthy uterus that's transplanted and having a baby.
The reason why I bring that up is this: there's no such thing as a donor egg emergency. So if you're over a certain age and you still want to have hope that you can carry a pregnancy with your own eggs, that's okay!
Because just having that hope believing in your own fertility... sometimes it works.
But if you feel pressure that you need to make a decision right away, know that you don't need to. Because if your ovaries aren't working, we don't need them when it comes to a pregnancy.
We use hormones like estradiol for a couple weeks and then you take progesterone and we mimic ovulation in this way. You continue those hormones through ten weeks of pregnancy.
You don't even need fallopian tubes to carry your pregnancy when it comes to using science like IVF.
So remember that no matter what your age is, some women run out of eggs even at an earlier age than they're supposed to, it's normal to run out over the age of 40. 10% of women in their 30s run out of healthy eggs but they can still carry a healthy pregnancy with the solutions I mentioned above.
Sometimes we have to be more creative about how we do things: using donated eggs, donor sperm, donated embryos and also using gestational carriers.
So no matter what your goals are, meet with a specialist talk to them about your goals. Don't use age as a limiting factor for you to be able to be a parent.
Get your fertility levels checked
I recommend for every young woman who has a family member who has gone through early menopause, to get your fertility levels checked. The FSH, estradiol and AMH. As well as genetic screens like fragile X and a chromosome analysis.
Every woman by the age of 25 should get her fertility hormone levels checked. Depending on your situation, your relationship status and your goals, consider doing egg freezing.
If a woman is 32 and would like at least two kids and isn't going to start trying for a family in the next 5 years, I strongly encourage her to freeze eggs or freeze embryos.
If you've had a baby, at your postpartum visit, get your levels checked. I see this so often that fertility myth, where people are told that if you have a baby, the next one is going to be easy. I wish that was true but this isn't the case.
So at your postpartum visit, if you haven't had your levels checked, get your AMH done, see what's going on.
Think about what you want to do next and don't wait too long to have another baby. If egg freezing or embryo freezing or something that you want to do, do it.
Birth control and early menopause
For everyone who starts birth control pills, especially at a young age, I need these women to get their AMH checked before you start them.
Then get your AMH checked every year or two, as you're staying on them so that you're not tricked by the birth control pills.
See, birth control pills can mask infertility. They make you feel like you're having regular cycles, but you're not. These cycles are induced by the hormones. If you weren't on the hormones, your periods might be irregular and then you would have seen someone and gotten your levels checked so you can have the option to preserve your fertility.
I have lots of stories of patients who started birth control pills at 17 stopped at 32 and never had a period later. Then they were diagnosed with something called primary ovarian insufficiency. Which is also known as early menopause. But had someone offered them this kind of testing that I'm describing to you, it could have been caught earlier. She could have had options that she doesn't have anymore.
Same thing for an IUD. Before you get an IUD placed inside the uterus, get AMH level checked. The IUD lasts 5 years, so some people just forget about their fertility. Get your AMH checked every couple of years after that and ask yourself the questions that I always ask my patients:
- How old are you?
- How many kids do you want?
- What is it gonna take to get what you want?
- Are you willing to do it?
My bottom line:
How old is too old to have a baby? Of course, there are limits. But certainly with more people freezing their eggs and with more and more people delaying childbearing, as fertility providers we have to be more open-minded about how we can help them have babies as safely as possible. Science allows us to give you different options.
For couples who want to explore non-invasive ways to increase their chances of having a baby, we suggest you check out our natural fertility supplements.