Advanced maternal age & fertility – why there’s hope + what to do

Getting pregnant after 35 or 40

If you’re 35 or older and have been given the idea that your fertility has pretty much fallen off a cliff because of your age, then this is for you. We’re going to look at what the actual data and research says on the subject, and I think you’ll find it encouraging.

We’re all familiar with this story – that we women are born with all the eggs we’re ever going to have, and that by the age of 35, they’re basically dried up and we’re infertile. But when you look at the data and the physiology of how the body works, it’s clear that this is just not true.

There’s not some magic age or number at which our fertility gets flipped off like a light switch. And it makes me so mad that we’re so frequently told this disempowering and frightening story. It hits home for me personally. I had my two babies right before my 37th and 40th birthdays. So I was “advanced maternal age” for both of my pregnancies. And honestly, I think it is so fantastic to have babies later in life.

What do the statistics say about age and fertility?

The commonly touted statics on age and fertility (the ones you've probably heard) are based on old data – French birth records from the years 1670 to 1830 - or based on modern data from IVF clinics whose patients may have underlying and long-lying reproductive health issues, rather than from conception rates in the general population. So the commonly touted statistics are misleading.

So what does the research actually say about your fertility and age? Let’s look at what current data from the general population tell us.

The natural monthly fecundity rate is about 25% between 20 and 30 years of age and decreases to below 10% above the age of 35. So that’s measuring monthly rates - the likelihood of getting pregnant each month - and sounds dismal, doesn’t it?

But what about if we followed women for longer than one month? Then what happens to the data?

A study published in Obstetrics & Gynecology in 2004 examined the chances of pregnancy in 1000 women when having sex twice a week. It found that 82% of the 35 – 39-year-old women conceived within a year. Compared to 86% of women between the ages of 27 and 34 conceived within a year. So the percentage difference between a 27-year-old and a 39-year-old is 4 percentage points. That’s it! It went from 86% in the 27-34-year-old group, to 82% in the 35-39-year-old group.

Another study out of Boston University following 3000 Danish women found that 78% of women aged 35 to 40 years get pregnant within a year of TTC compared to 84% of 20 – 34-year-olds. So there’s a 6 percentage point difference according to that study. That’s it!

What about advanced maternal age and chromosomal abnormalities?

What about the likelihood of chromosomal abnormalities, and how they relate to age? We all hear that the chances of having chromosomally abnormal babies dramatically increases as we age.

What the research does show is that complications do increase with age and that the biggest change happens after the age of 40, but even those are not super high.

Well, let’s look at the numbers. The research shows at 35, you have a 1% chance of having a chromosomally abnormal baby. At 40 that jumps up to 2%. So yes, there is an increase when we age that we can have some abnormality with the fetus? But it’s not a huge increase. At age 35, it's 1%. At age 40, it’s 2%. And at age 45, that’s where it really goes up, to 13%.

What you need to know about fertility and age

If you’re struggling to get pregnant and doctors don’t have an answer and they’re just blaming it on your age, please know that this is very likely an assumption they’re making.

If you’re 35 or older then it’s often just assumed that it’s due to your eggs being old, especially if they can’t find any other reason why you’re not conceiving.

Did you know that according to a very recent study performed on animals, scientists for the first time concluded that menopause does not start in the ovaries but in the hypothalamus — your master endocrine gland located in the brain which orchestrates all of the other endocrine gland functions?

In this fascinating study, the ovaries from menopausal animals were removed and placed into young menstruating animals to see whether they would resume their function even though they were considered ‘menopausal’ and therefore eggless and too old to create and mature eggs. Remarkably, those ovaries under the hormonal stimulus from the hypothalamus resumed their function and started producing eggs even though they were already ‘menopausal’. This means that menopause does not happen because of old or too few eggs.

Even in humans, when a woman reaches menopause she still has anywhere between 500 -1000 eggs in her ovaries which will never develop after menopause when the communication between the ovaries and the pituitary gland becomes disrupted. But this communication can be restored and maintained.

Age-related infertility is widely misunderstood and poorly treated. Fertility doctors often recommend IVF for women over 38 and donor eggs for women over 40. If you’ve been told this, please consider the following:

Firstly, just because you’re 38+ doesn’t automatically mean you can’t have a healthy natural pregnancy. Many women conceive naturally into their 40’s.
Secondly, as long as you have some ovarian reserve and you’re still ovulating, it’s possible to fall pregnant naturally using your eggs regardless of your age. Even if you have low AMH.
And thirdly, IVF can do nothing to improve chromosomal issues; it can only screen for them.

Why there's hope for fertility after 35 or 40

I’ve had clients get pregnant in their 40s, I’ve had women get pregnant with high FSH levels, and with really low AMH levels. So clearly, their eggs were not too old. I think doctors tell women this because really they have no other solution for you. And it kind of takes the responsibility off of their shoulders and shifts the blame onto you.

If you’re of reproductive age, if you’re ovulating, getting periods, not yet in menopause... then there is hope…

... and there is probably something else going on that is contributing to your difficulty conceiving, other than your age... and that you can actually address and improve.

It might be subclinical and not show up in labs and doctors would call it “unexplained infertility”; or might show up as diminished ovarian reserve, hypothyroidism, low progesterone levels, blood sugar levels, inflammation levels, cholesterol, DHEA.

All of these factors influence your fertility, and we can improve these factors holistically.

You can decrease inflammation levels, increase progesterone levels, support ovarian function, increase your cellular vitality, and improve your fertility and chances of getting and staying pregnant. And that’s what a good holistic fertility plan, like the Becoming Mama program, is designed to do.

Improving egg quality after 35 and 40

Our bodies are designed to last, regenerate and recuperate, providing we are feeding them the right foods and supplements and are living in healthy toxin-free environments.

Our fertility does decline a little bit with age, and miscarriage rates and chromosomal abnormalities increase with age. And at some point in our mid to late forties, we enter peri-menopause and are no longer able to conceive. But until then, you can do things to improve your ovarian function, hormonal balance, cellular vitality, and improve your fertility.

What’s most important is how we’re supporting our egg quality, ovarian function, hormone balance, and our cellular health overall. Time alone is not what leads to unhealthy eggs. It’s the factors they’re exposed to. Birth control, toxins, stress, inflammation, sleep, nutrition, circulation, autoimmunity – all of these affect our egg health.

And studies back this up.

Studies show that there is a huge variation in chromosomal abnormality rates between different women of the same age, including this one published in Fertility and Sterility in 2012. Meaning our fertility is not set in stone by our age, it varies based on other factors. Studies of IVF effectiveness show that “chronological age” is not always an indicator of “reproductive age” and that maternal age alone is not a useful predictor of successful embryo implantation and pregnancy.

There’s something else at play besides just our age. Which is great news! While our chronological age is out of our control, our reproductive age IS under our influence.

It turns out that it’s not the steady march of time that damages our eggs most, but rather the qualities of the environment in which our eggs live. Factors like inflammation, oxidative stress, toxins, hormonal imbalance, and poor blood-flow to the ovaries all adversely affect egg quality and chromosomal viability. In other words, it’s the quality of our health that really influences our fertility.

Research is showing that these factors disrupt intraovarian homoeostasis thereby compromising egg quality and fertility. And it’s the three months prior to it being ovulated that each egg is most susceptible to these factors.

This is wonderful news because while we can’t control our age, we can control and influence these other factors. With simple diet and lifestyle tweaks that reduce inflammation, tend to our mitochondria, and restore balance to our endocrine systems, we can boost our egg quality.

What to do to get pregnant more easily after 35

You need to prime your body for pregnancy – priming your body to be able to sustain a pregnancy and healthy baby, and address any underlying issues that disrupt fertility.

As I've shown above, there are many other factors that affect our fertility, factors that (unlike our age) we can control – like diet and lifestyle, like inflammation and ovarian function and hormonal balance. We can’t control our chronological age, but we can have an effect on the health and vitality of our cells. And that’s what I think we should focus on, and what I focus on in the Becoming Mama program and with my fertility coaching clients and patients. Because that’s the biggest opportunity we have.

I recommend taking a holistic approach to your fertility, and taking 3-4 months to prime your body for optimal fertility. Focus on optimizing your sleep, digestion, immune system, inflammation, eating habits, and exercise.

I’ve helped so many women who’ve been told their eggs are too old, to go on and conceive and have a healthy pregnancy and baby, and I want you to know that you can do this too.

I recommend taking a look at my posts on unexplained infertility and diminished ovarian reserve. There are great action steps and info for you there.

What I really want you to know is that much of the ‘age-related’ infertility in women pre-menopause is due to poor egg and cellular health which can often be addressed naturally. Many of my clients have had babies in their early to mid 40’s after being told they had virtually no chance.

Realize that the time you take to prepare your body properly will nearly always be time well spent in terms of improved egg, sperm and cellular health. Even if it means postponing your planned IVF cycle for a few months.

A natural approach like the Becoming Mama program can help you improve egg and sperm health, and rejuvenate cellular health and cellular signaling. These steps can significantly improve your biological age. You can also learn how to repair some of the time-related DNA damage and reduce the chances of chromosomal issues. The result: your odds of conception significantly improve, with or without IVF and despite the extra time you spend doing the program first.

The truth is you probably have more time than you think. My real hope is that this leaves you feeling empowered.

I hope you have a beautiful day, and remember, your fertile health is a daily practice.

Katie