11.08.2015

Is pregnancy harder in your 40s

Perhaps you've put off pregnancy to concentrate on your career, or because it’s taken you a while to find the right partner (Bewley et al 2009, Utting and Bewley 2011).
Chromosomal abnormalities in your eggs can raise the risk of miscarriage and birth defects. There's never been a better time to try to get pregnant as an older mum, given the range of fertility treatments available.
In your early forties you have about a one in five to one in 10 chance of a live birth per treatment cycle (HFEA 2011, NCCWCH 2013). You may wish to explore the idea of using donor eggs or frozen embryos to try to conceive, as it will increase your chances of having a baby (Klipstein et al 2005, Serour et al 2010, Utting and Bewley 2011). The risk of miscarriage and chromosomal problems is consistent with the age of your egg donor, who will be in her 20s or 30s. Probably the greatest advantage of waiting to have children in your 40s is that you are emotionally and financially ready for them. If you've been with your partner for a while you will have had the chance to get to know each other in all sorts of circumstances. Your income is likely to be higher, as you will have had time to establish yourself in your career. By the time you reach your 40s, you may have a sense that you've been there, done that.
As you approach the menopause, your hormones work harder to release an egg from your ovaries. If you have assisted conception, the follicle-stimulating hormones you'll be given also increase your chances of conceiving more than one baby (Utting and Bewley 2011).
If you do conceive, you are more likely to need extra care during your pregnancy (Franz and Husslein 2010, Montan 2007, Utting and Bewley 2011). All women are offered screening tests in pregnancy for genetic conditions, such as Down's syndrome. Age aside, there are steps you can take to give yourself the best chance for a normal pregnancy and a healthy baby.
If you are in your 40s, and have been having unprotected sex two to three times a week for three months, without getting pregnant, see your GP. Join now to receive free weekly newsletters tracking your baby’s development and yours throughout your pregnancy. Sadly, both miscarriage and ectopic pregnancy are more common in older women (Franz and Husslein 2010, Johnson and Tough 2012, RCOG 2011). If you’re over 35 and pregnant, you may have extra tests, antenatal appointments and interventions.


If you don't have any pregnancy complications or health conditions, you could ask for a more low-key approach. You’re also much less likely to be a smoker (HSCIC 2012, ONS 2013) and more likely to quit smoking in pregnancy if you do still smoke (HSCIC 2012).
All pregnant women are offered screening tests for chromosomal abnormalities (NHS UK NSC 2014).
A greater likelihood that your baby is in an awkward position at birth (Johnson and Tough 2012), particularly if you’re over 40 and expecting your first baby (Utting and Bewley 2011).An increased risk of fetal distress during labour, particularly for first-time pregnancies in women aged over 40 (Utting and Bewley 2011). However, some doctors take a cautious approach when you are an older mum and anticipate that you need more care because of the increased risks, even if your pregnancy is going well (Carolan and Frankowska 2011).I’m an older first-time mum. Taking antenatal classes while you're pregnant will let you meet other local women who are expecting. If you and your midwife or doctor think things are going to go wrong, you’re likely to feel stressed, which isn’t good for you or your baby (Byrom 2004). If Berry is controlling her diabetes, which it appears she is, she shouldn’t have any issues with a healthy pregnancy, experts say. Many 40-plus women do conceive, although there's no denying that your odds of getting pregnant are a lot lower than just a few years ago.
At 40, your chance of conceiving is about 20 per cent (based on the average annual rate of pregnancy per cycle), falling to less than five per cent by the mid-40s (NCCWCH 2013:65). As early as 15 years before you go through menopause, the number of your eggs begins to decline. Your life experience means you'll feel pretty confident about your approach to child-rearing (Hansen and Joshi 2008). You'll be less concerned with your own needs, and will be happy instead to focus on your child.
From your mid-40s, if you conceive naturally, you have a one in two chance of having twins (NHS Choices 2010a, Utting and Bewley 2011).
Your age will be factored in to the result to give you a risk of your baby having a problem. But keep in mind that there are plenty of women in their 40s who have trouble-free pregnancies and perfectly healthy babies. Most specialists start with blood tests and investigations to check your fallopian tubes or your partner's sperm. The rate of miscarriage increases steadily, so that by the age of 45, you have about a one-in-two risk of miscarrying if you conceived naturally with your own eggs rather than donor eggs (Johnson and Tough 2012, RCOG 2011). Your age will be taken into account when working out the risk of your baby having a problem.


If you’re 40 or older, you may be offered induction at 39 weeks to 40 weeks because it may reduce your risk of stillbirth, particularly if you have other complications (RCOG 2013).
If this is the case, you may find it takes you a while to build a support network of friends in your local area. Having more life experience under your belt can bring maturity and better coping and parenting skills (Byrom 2004, Johnson and Tough 2012, Thomson et al 2014). The 46-year-old actress, the first African American to win a Best Actress Academy Award (for Monster’s Ball in 2002), announced she was pregnant.
By your 40s, the eggs that your ovaries release each month are more likely to have structural problems (chromosomal abnormalities). From 43 to 44 onwards, your chances of success using your own eggs really are minimal, because conception rates per cycle of IVF are so low. The two eggs can be fertilised and implant in your uterus, resulting in non-identical twins. But what it means is you'll get the care you need to ensure you and your unborn baby stay as well as possible. One last chance for pregnancy: a review of 2,705 in vitro fertilization cycles initiated in women age 40 years and above. Most have perfectly healthy pregnancies and babies but being an older mum can affect your pregnancy and the birth (RCOG 2011).
These conditions can affect how well your pregnancy and birth goes, as well as your health (Franz and Husslein 2010, Utting and Bewley 2011).
The 24-hours-a-day responsibility of caring for a baby may come as a shock that's hard to adjust to (Byrom 2004, Miller 2011).
No complications right now but after having a miscarriage you still have that worry in the back of your mind.
Most consultant-led hospital antenatal clinics are run by midwives and you may be offered an appointment with a doctor only at certain points in your pregnancy.
I have been advised I will be under a consultant as high risk but I haven't got my scan until I'm nearly 14 weeks which I am worried about as I can't settle until I know everything is ok with this pregnancy.
Even in women using the assistance of IVF (in vitro fertilization), there has never been a clearly documented case of a baby being born from an IVF pregnancy in a woman older than age 45 using her own eggs.



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