Trying to conceive over 40 is not uncommon. More and more women are choosing to delay pregnancy for several reasons, in fact approximately 4.5% of Australian women are giving birth at ages 40+ and this percentage is increasing more than ever before (Australian Institute of Health and Welfare, 2024).
However, it’s important to understand that fertility rates naturally decline as we age, particularly from our late 30s onwards. We know you’ve probably heard it all before, but still, we encounter people who’ve never really contemplated the potential challenges of starting a family in their 4th decade.
Our goal is to not make you feel pressured about trying to conceive, but provide the facts so you can be armed with the knowledge to move forward on your path to grow your family!
The chances of conceiving naturally each month drop from about 25% in our mid-20s to just 5% by age 40 (American Society for Reproductive Medicine, 2012). I know, these numbers can be slightly scary, but it’s essential to approach this journey with healthy expectations and have a plan in place.
Why Does Age Have Such a Big Impact on Female Fertility?
As women, we’re born with all the eggs we’ll ever have—no chance for a reset or do-over.
Throughout our lives, these eggs experience everything right along with us, from the late nights in our 20s drinking, experimenting with substances, smoking, or perhaps not always making the best diet or lifestyle choices. While these experiences are a typical part of life for many, it’s important to remember that our eggs don’t get a refresh button, like sperm do.
Additionally, approximately 20% of all human eggs are aneuploid (Jones, 2008), meaning they have an incorrect number of chromosomes—either too many or too few. This may mean that the a resulting embryo may be affected by a genetic disorder, or is not compatible with life.
As we get older, the number of aneuploid eggs rises, which sadly increases the risk of miscarriage. For women aged 35-39, the risk is around 35%, but it jumps to 51% between ages 40-44, and by 45, it’s as high as 93% (RACGP). Unfortunately, this is a natural part of the ageing process that we can’t significantly change or screen for. Although scientists are working on it!
On top of this, the total number of eggs we have naturally decreases over time, and this decline speeds up as we approach our 40s.
Unfortunately, there’s nothing we can do to stop it. However, we can measure our remaining egg count through an AMH (Anti-Mullerian Hormone) test—find out more about that here. But keep in mind, this number only tells us quantity, not quality. The genetics and health of our eggs, which are arguably even more important, are factors we can actually work on!
Trying to Conceive Over 40? Top Tips Before You Start
1. Get Some Pre-Conception Lab Work Done Through a GP
Even if this isn’t your first pregnancy, it’s still important to get pre-conception lab work done. This helps identify any potential barriers to conception and ensures you’re in the best possible health before trying to conceive. It’s highly encouraged, and GPs will be more than willing to help you with this process.
2. Know Your Timelines
If you’re experiencing issues like painful, irregular, or heavy periods, or if you have a medical history that could impact your fertility, it’s important to seek help from a fertility specialist sooner rather than later.
This is also crucial if you’ve experienced a pregnancy loss or are dealing with recurrent pregnancy loss. For women over 35, it’s generally recommended to seek assistance after trying to conceive for 6 months.
Don’t hesitate to reach out for support—timely intervention can make all the difference.
3. Know Your Menstrual Cycle
Take the time to get to know your menstrual cycle better.
Understanding the different phases—the follicular phase, luteal phase, and the signs of ovulation—can help you pinpoint your fertile window. This knowledge allows you to time intercourse more effectively.
4. Understand What You Can and Cannot Control
Non Modifiable Factors:
- Age – sorry, no time machines here!
- Conception Partner’s Age – if you have a male partner, his sperm health is a critical ingredient to your trying to conceive journey.
- Family history
- Genetics
- Number of Aneuploid eggs
- Medical History – such as endometriosis and other autoimmune conditions.
- The age you may experience menopause
Modifiable Factors:
- Diet & Nutritional Intake
- Physical Activity
- Environmental Exposures (Endocrine Disrupting Chemicals)
- Smoking
- Alcohol
- Drug use.
While trying to conceive in your 40s can no doubt be more challenging, seeking support early is crucial. It is important to build your support team from the start, including mental health professionals, nutrition support and linking with a trusted GP and fertility specialist after 6 months of trying without success.