Having Kids Later in Life

July 2022

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Healthy pregnancies as you age

There are many reasons why you may be waiting to have children. You may want to focus on your career. Or save money first. About 20% of women in the US now have their first child after age 35.

You may have heard that it can be harder to get pregnant as you get older. Or that it is more risky for both the mother and the baby’s health. Although having children later in life can be difficult, many concerns are manageable.

To get pregnant

Getting pregnant can be more difficult with age. There are many reasons for that. One is that fertility declines as you age—for both men and women.

Women are born with a set number of eggs. Every month a woman’s ovary releases an egg to be fertilized. This process is called ovulation. But before that, her body recruits many eggs in preparation for this process. A handful of eggs are developed and mature, but usually only one reaches ovulation.

“As women get older, they are still fertile, but their chance of pregnancy is reduced because they are not making as many good eggs that will fertilize and divide normally and turn out to be an embryo,” explains Dr. Alan Decherney, an NIH fertility expert.

After age 30, a woman’s fertility declines every year. The number and quality of her eggs decline until she reaches menopause. Menopause usually occurs around the age of 45 to 55. During that time, women stop having their periods and are no longer fertile.

Older men may make less sperm or lower quality sperm. The age-related decline in egg and sperm quality is associated with a greater chance of the child developing certain health conditions. These include autism spectrum disorder, Down syndrome and schizophrenia.

But most healthy women who give birth in their 30s and 40s have healthy babies.

Pregnancy problems

If you’re over 35 and haven’t gotten pregnant after trying for six months, talk to your healthcare provider. You may experience problems with infertility. Infertility is when a couple cannot conceive or a woman has been unable to carry a pregnancy to term.

NIH-funded researchers study the causes of infertility for both men and women. There are many reasons for infertility.

“The most common cause of infertility in women is related to ovulation abnormalities,” said Dr. Esther Eisenberg, who oversees reproductive medicine and infertility research at NIH.

Many factors affect your ovulation cycle. Being a parent is one of them. You may not ovulate regularly, or sometimes not at all.

Another cause of infertility is endometriosis. It is a disease in which tissue that is normally found in the uterus (womb) grows outside of it. Endometriosis can cause painful periods, urination or bowel movements. It accounts for at least a third of infertility in women. It is more common for women in their 30s and 40s.

Fibroids are also more likely as you get older. These are abnormal growths made from the uterus’ muscle cells. They can grow inside or outside the wall of the uterus. These growths can prevent a woman from becoming pregnant. Most women get at least one fibroid in their lifetime. But they are most common between the ages of 40 and 50.

Other causes of infertility can be treatments for certain health conditions. “Women who have been treated for cancer may have a reduced number of eggs,” says Eisenberg. “If you’ve had other conditions that require surgery to remove an ovary or fibroids—in which you’ve had surgery on the uterus—these can also affect your fertility.”

Seek help

“If it becomes a problem having a child, there are treatments,” says Eisenberg. “The majority of women can have a child with help.”

Treatments for infertility depend on the cause. Endometriosis and fibroids can be treated with drugs, surgery and other methods. Medicines can help stimulate ovulation. These are called fertility drugs. Some are taken orally and others are injected.

Other options may be assisted reproductive technologies. Examples include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). These procedures help you get pregnant through different methods of fertilizing an egg.

Decherney’s group studies egg preservation, which involves freezing eggs. It can help some women who face health conditions that can reduce fertility. “But it’s expensive,” he notes.

Stay healthy

Infertility is not the only problem older couples face. “Whether a woman can have a baby as she gets older also depends on her health,” says Decherney. “The chances of having diabetes or high blood pressure – which are the two main diseases that affect pregnancy – are higher.”

Obesity, heart conditions and cancer can also interfere with a woman’s ability to get pregnant or stay pregnant. They can also lower men’s fertility.

Talk to your healthcare provider before you get pregnant. They can help you plan for a safer pregnancy.

Being older when you are pregnant also makes you more likely to experience health problems as a result of pregnancy or childbirth. These include heart disease, infection, bleeding, high blood pressure and blood clots.

High blood pressure puts pregnant women at greater risk for preeclampsia. Preeclampsia is a serious medical condition that can cause you to go into labor early. It can also lead to death.

No matter your age, you have a better chance of getting pregnant and staying pregnant by living a healthy lifestyle. See the Wise Choices box for tips.

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