Is Pregnancy Possible after 40?


As promised, each Thursday, we will now offer you a piece of educational, science, or research related information. The purpose of our #ThursdayThoughts post is to share with you fact-based content that can enlighten and assist you on your fertility journey. Enjoy our post! Helping to Create New Beginnings….

Is Pregnancy Possible After 40?

The good news: As a society, we are ageing well! We are healthier and live much longer lives now than we did just 50-years ago. Technology and medical advances have improved allowing for this increased lifespan. Our clinic also offers oocyte (egg) preservation for women who want to start a family later in life when they are ready.

The bad news: The ovaries and eggs have not evolved to keep pace with the society norm. Two things happen to oocytes as a woman gets older. The oocytes decline in number and in quality, and success goes down as the oocyte ages. For most women, the ability to get pregnant, in a given menstrual cycle with intercourse, at or after the age of 40 is approximately 5% or less per month.

Why does pregnancy success diminish with age?

It’s a normal part of human physiology. Women are born with all their eggs. Think of it as a full moon that is waning. Women lose a certain number of eggs every month, by the time a woman reaches their early to mid-forties they run out of eggs.

Let’s get technical:

“The oocytes undergo a process called atresia. At birth, approximately 20% of the oocytes remain and at the time of puberty only 5% to 10% of the oocytes remain. This decline in the number of oocytes continues throughout life and results in a very low number of oocytes remaining when a woman reaches the age of 40. Ultimately, most women will run out of viable oocytes in their early to mid-forties.”

However, it is not only the declining number of eggs that is a problem it is also a matter of the age of the egg. As the age of the body and the egg increases, its ability to fertilize and develop into a healthy (chromosomally normal) embryo is compromised.

This is why miscarriage rates are higher and pregnancy rates are lower for women who are forty and older.

What are my options?

If you are in your 40s, the best thing to do is to get a full fertility evaluation to see the status of your ovarian reserve.

How is this done?

We do a few procedures in-clinic to check the lining of the uterus, number of follicles in the ovaries (via a transvaginal ultrasound), and draw blood to measure AMH (Anti-Mϋllerian Hormone) levels. This is a must to create a treatment plan to help you get started on your family building journey.

While there are certainly many women who are fertile in their forties, there are many who are struggling with infertility. Other options for fertility success include: attempting natural conception, ovulation induction with intercourse or intrauterine insemination (IUI), In Vitro Fertilization (IVF), donor oocyte with IVF, gestational carrier, donor embryos, or adoption.

In summary:

Fertility treatment options for women are similar regardless of age. Keep in mind what differs is the success rates with each option. For example: A 40-year-old patient with a normal uterus and ovarian reserve who undergoes ovulation induction with timed-intercourse or IUI will offer at most a 5% pregnancy success rate per month, IVF success rates using their own eggs can be as high as 40% to 50%, and donor egg IVF success rates can be 80 to 90%. A thorough evaluation that allows for an individualized assessment can offer more useful predictive success rates.

The reality is that almost every patient can have a child! However, the path to that success may not be the original path that was anticipated. For more information regarding treatment options that are available, please visit our website or contact us.

For more information regarding treatment options that are available, please schedule an appointment with one of our providers at the Fertility Institute of Hawaii 808-545-2800 or visit our website

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