Getting Pregnant over 40

1. Pregnancy in your 40s If you're over 40 and planning a baby you're joining a growing group of older mums in the UK. The fertility rate for women who become mothers at 40 and over has trebled since 1991,i with women conceiving naturally and benefiting from advances in IVF and egg donation techniques. Being an older mum has pluses and minuses; the downside is you're less fertile and are more likely to have complications in pregnancy; but the upside is you're more likely to be settled in life with greater financial security and be established in your career. These days you can't open a newspaper or a magazine without coming across celeb mums who've given birth in their 40s - Halle Berry, Nicole Kidman and Julianne Moore are just three Hollywood actresses holding back the years for motherhood. But is it really that easy to get pregnant once you're over 40? Fertility over 40 Getting pregnant over 40 can be more difficult, mainly because the quality of the eggs you produce begins to decline and you don't always ovulate (produce an egg) every month. Around two-thirds of couples over 40 experience difficulties conceiving.ii Women over 35 are also less likely to get pregnant as a result of IVF and are more likely to have a miscarriage if they do conceive. Men's fertility also begins to decline over the age of 40 although they can still father children until well into their 60s and beyond in some cases.iii Boosting your chances of getting pregnant On the positive side though there are lots of steps you can take to improve your chances of conceiving over 40. These include: Stopping smoking: Smoking at least 20 cigarettes a day can bring forward your menopause by two years. Smoking can also damage male sperm.iv Keeping to a healthy weight: Being overweight or underweight can decrease your chances of getting pregnant. Avoiding alcohol: Alcohol affects fertility in women and men and is best avoided if you want to conceive. A study in Denmark found women who drank between one and five alcoholic drinks a week reduced their chances of getting pregnant and 10 drinks a week cut the likelihood even further. Too much alcohol lowers the male sex hormone testosterone in men and sperm quality.v Real mum's story Marketing manager Lesley Williams, 44, mum to two-year-old Alice, lives in London and didn't start trying for a baby until she was 40 when she met her husband Phil, 45, an estate agent. 'Because we realised we'd left it quite late in life to become parents we booked a private pelvic ultrasound scan just to check everything was okay in my womb. It was really reassuring to know my ovaries and uterus were fine and I didn't have any fibroids or adhesions,' recalls Lesley.

2. 'We were very lucky I became pregnant naturally after 16 months - we had booked our first appointment to discuss IVF only a few weeks before.' 'We felt the pregnancy was especially precious given our ages and couldn't wait for the first NHS scan at about nine weeks. We both felt a mixture of excitement and anxiety and just wanted some reassurance early on, so we booked a private early pregnancy scan with Ultrasound Direct at seven weeks to check everything was okay. We were able to see the baby's heartbeat and were reassured she was measuring the correct size for her dates.' Because the risk of a baby having a chromosomal abnormality such as Down's syndrome rises in babies born to women over 40, Lesley and Phil opted to have the Non-Invasive Prenatal Test (NIPT and scan) offered privately by Ultrasound Direct available between 10 and 22 weeks. This combines the Harmony blood test for Down's syndrome and an ultrasound scan to check the baby's heartbeat, wellbeing and growth and calculates the risk of your baby having a chromosomal abnormality. The scan is in 4D so you get to see the baby moving in real time. 'We received the blood test results seven days later,' says Lesley. 'The best thing was seeing Alice in such incredible detail and finding out we were having a daughter,' recalls Lesley. 'I did book some more private ultrasoundscans during the pregnancy for reassurance - to check the baby's wellbeing, including the quickASSURE™scan and growth scans offered by Ultrasound Direct, but there was always a sound underlying medical reason for them.’ 'I was warned I may be at higher risk of complicationsviincluding pre-eclampsia (a pregnancy high blood pressure condition) and stillbirth in my pregnancy because of my age but everything was fine and I had a natural delivery at 38 weeks.' IVF and egg donation If you're over 40 and worried you've left it too late, it may be sensible to consider IVF sooner rather than later.More than 221,555 IVF babies were born between 1991 and 2012 in the UK and now 2.2 per cent of all babies are conceived in this way.vii Although IVF is less successful in women aged over 40, the good news is new techniques are increasing success rates. The live birth rate per cycle of IVF for women using fresh eggs aged 40 to 42 was 13 per cent in 2012 and 4.4 per cent in those aged 43 and over.viii But the live birth rate per cycle of IVF for women using donor eggs aged 40-42 was 40 per cent in 2012, and 33 per cent in women aged 43-44 and 35.3 per cent in women aged 45 plus. Extra scans for the over 40s By 40 the risk of having a baby with Down's syndrome rises to one in 100 and at 45 it's one in 50 or greater.ix The over-40s are also at higher risk of complications in pregnancyx. Because of this they often request more private ultrasoundscans during pregnancy for added reassurance including quickASSURE™ and growth scans. ihttp://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birth summarytablesenglandandwales/2015-07-15#live-births-by-age-of-mother

3. ii http://www.nhs.uk/Livewell/Fertility/Pages/Protectyourfertility.aspx iii http://www.nhs.uk/Livewell/Fertility/Pages/Protectyourfertility.aspx iv http://www.nhs.uk/Livewell/Fertility/Pages/Protectyourfertility.aspx v https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/fertility-and-pregnancy/is-alcohol- harming-your-fertility vi https://www.rcog.org.uk/en/news/rcog-statement-on-later-maternal-age/ vii http://www.hfea.gov.uk/docs/HFEA_Fertility_Trends_and_Figures_2013.pdf viii http://www.hfea.gov.uk/docs/HFEA_FertilityTrends_and_Figures_2013.pdf ix http://www.nhs.uk/conditions/Downs-syndrome/Pages/Introduction.aspx x https://www.rcog.org.uk/en/news/rcog-statement-on-later-maternal-age/