The decision to become pregnant is individual. More and more women choose to do so later in life. Today, pregnancy after 40 no longer raises eyebrows. However, it may be associated with an increased risk of complications for both mother and baby. What should women deciding on pregnancy after 40 know?—described by midwife Alina Jedlińska, ambassador of the campaign “Midwife of the Year”.
Pregnancy and age
It is no secret that the chances of becoming pregnant decrease with age. The number of ovulatory cycles also declines and falls with each subsequent menstrual cycle.
Women are most fertile between ages 19 and 25. Many, however, postpone motherhood and, for economic or social reasons, start trying after 30 or even after 40.
Pregnancies after forty are usually very intentional. Women who decide on them often have a stable financial situation, are in their professional prime, and their family situation is as they envisioned.
Another group includes women who become pregnant after forty after a long wait, having struggled with the modern problem of infertility.
How to prepare for pregnancy after 40
A woman planning pregnancy after 40 should prepare well and undergo a series of laboratory tests. One of the most important indicators is the ovarian reserve test—AMH. It shows whether the ovaries can produce oocytes. According to experts, the greatest chances of conception are in patients with AMH above 2.4 ng/ml, and the lowest in those below 0.2 ng/ml. From clinical experience, pregnancies can occur with AMH 0.1 ng/ml, but this is relatively rare.
Remember that a very high AMH does not always indicate excellent fertility; it may also point to polycystic ovary syndrome—one cause of infertility.
Another important test is FSH measured in blood (a hormone that stimulates follicular maturation).
It is also worth checking serum vitamin D, which is important for proper pregnancy development. Infectious screening for toxoplasmosis, rubella, cytomegalovirus, HIV, HBs, HCV, and syphilis is also essential.
For women planning a child after 40, a family history of genetic defects and hereditary diseases should be taken. Physical fitness, proper diet, and a healthy lifestyle are also important.
It is recommended that a woman planning pregnancy start folic acid supplementation at 0.4 mg/day for 3 months before trying to conceive to minimize the risk of neural tube defects in the fetus.
A woman who becomes pregnant after 40 is considered high-risk, as she is more prone to miscarriage and health complications, including hypertension, diabetes, and perinatal complications.
Statistics are unforgiving and studies indicate that maternal age is one of the most important risk factors—women over 35 more often give birth to children with genetic abnormalities.
Modern medicine is well advanced and, to a great extent, enables a safe pregnancy and a happy outcome. Doctors emphasize that despite the high risk, as many as 96% of women give birth to healthy children, which results, among other things, from high patient awareness and regular preventive examinations.