Fertility After 40

Fertility After 40: It’s Not Over Until It’s Over!

So, you’ve hit your fabulous 40s, and the idea of becoming a mom has been dancing in the back of your mind for a while. But now you’re wondering, Can I really get pregnant after 40? Is it still possible to have a baby in your 40s, or is it time to pack away those baby clothes for good?

Here’s the good news: It’s not over until it’s over! Yes, fertility naturally declines as we age, but many women still conceive naturally and have healthy pregnancies well into their 40s. Let’s dive into everything you need to know about fertility after 40 and how to maximize your chances.

Fertility After 40

Understanding Your Fertility After 40

First, let’s get one thing straight: Your fertility doesn’t vanish as soon as you hit 40—but it does start to slow down. As women, we’re born with a finite number of eggs, and as we age, both the quantity and quality of those eggs decrease. By the time you reach your 40s, the chances of having a baby naturally are lower than they were in your 20s or early 30s, but it’s still possible!

Here are some important things to keep in mind about fertility after 40:

1. The Egg Countdown:

By the time you turn 40, your body has fewer eggs, and those eggs that remain are more likely to have chromosomal abnormalities. This can increase the risk of miscarriage and conditions like Down syndrome. However, the good news is that many women in their 40s still conceive without complications.

2. Menstrual Changes:

As you approach perimenopause (the transition to menopause), your menstrual cycles may become irregular, which can make it more difficult to predict ovulation. Tracking your cycle and getting to know your body’s unique signs is important.

3. Hormonal Shifts:

You may experience hormonal fluctuations during perimenopause, including changes in estrogen and progesterone levels. These changes can affect the regularity of ovulation, which in turn can impact your fertility.

How to Maximize Your Fertility After 40

The fact that fertility decreases doesn’t mean it’s impossible to get pregnant after 40—it just means you might need to be a little more intentional. Here are some expert-backed tips to help boost your chances of conception:

1. Track Your Cycle (Yes, Again!)

You probably tracked your cycle in your 20s or 30s, but it’s even more important to track it in your 40s. Why? Because it’s harder to predict ovulation when you’re older, and knowing when you’re most fertile can help you time intercourse. There are plenty of apps and tools to help you track ovulation, or you can also consider ovulation predictor kits (OPKs) that measure hormone levels.

2. Get a Preconception Checkup

Before you start actively trying to conceive, it’s a great idea to visit your gynecologist or fertility specialist for a preconception checkup. They can help assess your fertility health and identify any underlying issues that might make conception harder, such as fibroids or thyroid problems. A doctor will also discuss your health history and provide advice on how to optimize your fertility and overall health.

3. Keep Your Eggs Happy (and Healthy!)

If you want to keep your eggs in tip-top shape, focus on eating a nutritious diet, maintaining a healthy weight, and managing stress. Omega-3 fatty acids (found in fish like salmon), antioxidants (berries, leafy greens), and folate (found in leafy greens and beans) are all great for supporting your reproductive health. Also, don’t forget about vitamins—folic acid is a must when trying to conceive.

4. Maintain a Healthy Weight

Maintaining a healthy weight is crucial for fertility, as being overweight or underweight can affect hormone levels and ovulation. If you’re struggling with weight management, talk to a nutritionist or healthcare provider to create a plan that works for you. Remember, your body needs the right balance to produce and release eggs!

5. Say Bye-Bye to Smoking and Excessive Drinking

If you smoke, now is the perfect time to quit. Smoking has been shown to accelerate egg loss and can damage the DNA of your eggs. Similarly, while moderate drinking might be fine for some women, excessive alcohol consumption can harm your fertility, so it’s wise to cut back if you're trying to conceive.

6. Consider Fertility Testing

By your 40s, you may want to consider fertility testing to get a clearer picture of your reproductive health. Tests like AMH (Anti-Müllerian Hormone) can give an idea of your ovarian reserve, and FSH (Follicle-Stimulating Hormone) levels can show how well your ovaries are functioning. Your doctor may also suggest an ultrasound to check for conditions like polycystic ovary syndrome (PCOS) or endometriosis, which can affect fertility.

When to Consider Fertility Treatment

If you’ve been trying to conceive naturally for six months to a year without success, it might be time to consider fertility treatments. While there’s no guarantee, options like IUI (intrauterine insemination) and IVF (in vitro fertilization) can increase your chances of pregnancy. IVF, in particular, is a popular option for women over 40, as it allows doctors to fertilize an egg outside the body and implant the healthiest embryos into the uterus.

Additionally, egg freezing (called oocyte cryopreservation) might be an option if you want to delay pregnancy but still preserve your fertility. This procedure involves retrieving and freezing eggs while they’re in their prime for later use.

Emotional Support: Fertility After 40 Can Be Stressful

Trying to conceive a pregnancy after 40 can be emotionally challenging. The pressure, uncertainty, and rollercoaster of emotions that come with trying to start or grow your family can be overwhelming. It’s essential to take care of your mental health during this time.

Consider seeking support groups, talking to a therapist, or connecting with others who are in similar situations. Many people find that talking about their experiences makes the journey feel a little less isolating.

When to Seek Professional Help

You should consult with a fertility specialist if:

• You’ve been trying to conceive for more than six months to a year without success

• You’ve had miscarriages or problems with your menstrual cycle

• You’re concerned about your hormone levels or overall reproductive health

• You’re experiencing any unusual symptoms, like pelvic pain or irregular periods

The Bottom Line: It’s Never Too Late—But It Might Be Harder

Fertility after 40 may not come as easily as it did in your 20s or 30s, but it’s not impossible. By taking steps to optimize your health, understanding the challenges, and consulting with a fertility specialist, you can increase your chances of pregnancy.

Most importantly, don’t lose hope. Many women in their 40s successfully conceive and go on to have healthy pregnancies. Whether you choose to conceive naturally or with the help of medical interventions, remember that every journey is unique, and there’s no one right way to build your family.

Book an appointment with Dr. Kameelah Phillips today at Calla Women's Health, the leading female menopause specialist in NYC!​

Dr. Kameelah Phillips is affiliated with Lenox Hill Hospital in Manhattan, New York. As a NAMS Certified Menopause Practitioner (NCMP), she focuses on patient care throughout all life stages, specializing in menopause and midlife healthcare.