Getting pregnant at 40 is possible. Who doesn’t have around them an aunt, a friend, an acquaintance who got pregnant in their forties? However, it is more difficult to get pregnant at 40 than at 20. The older a woman gets, the more her fertility weakens. But how to explain it? ” A woman is born with a stock of oocytes which is formed when the fetus is 3 months old », Explains Prof. François Olivennes, obstetrician and infertility treatment specialist, on the Pourquoi Docteur website. ” When she is 40, her oocytes are therefore 40 years old. They are less numerous, and especially aging, even if it is shocking to say. “

According to figures from the National Institute of Demographic Studies (INED), a woman who wants a child at age 30 has a 93% chance of getting there, at 35, she gets there in 85% of cases and at 40, in 65% of cases.

What solutions?

Getting pregnant without having medically assisted procreation (ART), is it so complicated? According to statistics, the probability of conception in a woman is 25% every month at 25 years, 12% at 35 years and 6% at 40 years. It is therefore possible but it will be necessary to be patient if the pregnancy is slow in coming. The various experts on this question explain thatat 40, it is still possible to get pregnant with your own eggs, but after 45 years it becomes almost impossible.

If the wait is too long, a woman over 40 may turn to in vitro fertilization (IVF) or to egg donation. The age limit for social security coverage has been set at 43 for IVF with own oocytes and at 49 for donation of oocytes. But it must be said that IVF with its own oocytes is unlikely to be successful after 40 years. According to official figures, IVF with one’s own oocytes which results in a birth is very rare after 44 years. The success rate is then approximately 2% per attempt.

What risks?

You should also know that after 40 years, the risks of having a child with Down’s syndrome are greater. The rate of chromosomal abnormalities in oocytes increases with age. At age 21, about 30% of oocytes are carriers of chromosomal abnormalities; at age 40, about 60% of oocytes have abnormalities ; and after 44 years, this anomalies rate is 90%.

In addition, the older the woman, the greater the risk of miscarriages. Between 40 and 44, the risk of miscarriage is 34%. It reaches 53% in women over 44 years old. For comparison, the miscarriage rate is 10% at 20 years and 12% at 30 years.

Finally, we must not forget that after 40 years, certain complications can arise during pregnancy. The most common complication is gestational diabetes, with a risk that the baby will grow and gain too much. There are also risks of hypertension, phlebitis, pulmonary embolism, fibroids or even delivery by cesarean section.

The mother should also know that the risk of childbirth mortality increases with age : mortality is indeed multiplied by two among women aged 35 to 39, by three among those aged 40 to 44, and by ten among those aged 45 and over. Women must be warned.

What advice …

To increase the odds in their favor, women who wish to have a late child are recommended to quit smoking, not drinking too much alcohol, avoiding medications, engaging in regular physical activity and ‘have a calm and collected life. They should also be careful not to gain too much weight. : the risk of not conceiving a child is indeed increased by 30% in the event of overweight and by 80% in the event of obesity.

Claire Verdier

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