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Today, many healthcare professionals gauge pregnancy risk by the pregnant woman's health status, not her age. Pre-existing medical conditions are the most significant indicator of a woman's wellbeing during pregnancy and the health of her developing baby. For example, a healthy 39-year-old woman is less likely to develop pregnancy problems than a woman in her 20s who suffers from diabetes. A woman's fitness level can have a greater effect than her age on her pregnancy.
Most women who become pregnant in their 30s and 40s are in good health. A woman in good physical condition who has been exercising regularly may go through pregnancy as easily as a woman 15 to 20 years younger. An exception: Women in a first pregnancy after age 40 are somewhat more likely to encounter complications than women the same age who have had children. But most healthy women will have a safe delivery. Some health problems are age related-the risk of developing the condition increases with age. High blood pressure and some forms of diabetes are age related. You may not know you have these conditions unless you see a doctor regularly. Either condition can complicate a pregnancy and should be brought under control before pregnancy, if possible.
Age affects fertility, which begins to decline when a woman is 20 and declines faster after 35. Couples older than 35 may take twice as long to conceive a child as a younger couple (1 Y2 to 2 years). A woman older than 40 may take longer to conceive because of the declining number and quality of eggs in the ovaries and because ovulation is less frequent. The good news is that advances in fertility and reproductive technology have helped women conceive who might never have conceived before. Your doctor can learn more about your ovulatory cycle by administering a test called the clomiphene challenge, which involves administering a drug to test the ovaries.
You may also be advised to use a home ovulation-predictor kit, which can help confirm if and when ovulation occurs. A variety of them are available on the market today. The kit works by measuring the increase or surge of luteinizing hormone (LH) in a woman's urine. This hormone is made in the brain and promotes maturation of the ovarian follicle, resulting in ovulation. LH increases and can be detected 24 to 40 hours before ovulation. Kits range in price from $20 (a one-time-use test) to a few hundred dollars (kit can be used repeatedly) .
Other factors can affect fertility. One study showed that drinking even one alcoholic beverage can lower a woman's chances of getting pregnant. Caffeine can also affect a woman's ability to conceive.
Some older couples turn to assisted reproductive technology (ART) to achieve pregnancy. ART includes in-vitro fertilization and gamete intrafallopian transfer (GIFf), in which a donor egg is paired to the partner's sperm. Success relates to the woman's age. For women at 34, the success of in-vitro fertilization is about 20% per menstrual cycle. At 44, a woman can expect a 5% success rate with this procedure.
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