Fertility after 35: Your questions, answered

It’s no secret that age affects fertility. As you approach your mid-30s, you may wonder, “How old is too old?” and “What are my chances of getting pregnant?” This is especially true if you are longing to start a family or add to one.

Dr. Arlene Morales, a Sharp Community Medical Group reproductive endocrinologist, answers some frequently asked fertility questions to help put curious minds at ease. Spoiler alert: The chances of getting pregnant look pretty good after 35.

How does age affect someone’s fertility?
Age affects fertility differently in men and women. For men, changes in fertility are subtle and begin around age 40 and are more prominent at age 50 and beyond. However, men are still able to contribute to pregnancy into their 70s. For women, it’s a different rate of change. A woman’s most fertile years are in her 20s. Fertility gradually declines in the 30s:

• At age 30, a woman has a 20% chance of conception each month. Up to 85% of women at this age will be pregnant within the first year of attempting conception.

• At age 35, there is a 15% chance per month of conception.

• At age 40, the chance of conception is 5% per month. About 44% of women in their 40s will conceive within one year.

Given these statistics, the recommendations are to proceed with an infertility evaluation if pregnancy does not occur after 12 months of attempting conception in women under 35 or after six months in women over 35.

What are some challenges of naturally conceiving after 35?
Every situation is unique. There will be no problems conceiving for some healthy women over 35 and for others, there will. Women can experience fertility issues with their second or third baby, even after having no trouble conceiving their first child.

For those who do conceive, the miscarriage rate also increases with age. There is a 15% chance of miscarriage in your 20s that rises to over 40% at age 40.

What healthy habits can someone incorporate to improve fertility?
Your eggs age as your body ages, and that can impact your chances of getting pregnant. However, there are ways to help your body prepare to conceive after age 35:

• Visit your primary care physician to ensure you are healthy enough to conceive and carry a baby.

• Stay up to date on your routine screenings, preconception labs and vaccinations.

• Maintain a healthy BMI (body mass index).

• Take a prenatal vitamin with folic acid.

• Discontinue any nicotine or cannabis use and exposure.

• Limit caffeine to under 200 milligrams per day.

• Have a reasonable intake of alcohol (no more than five to 10 drinks per week).

How can someone increase the chances of naturally conceiving after 35?
Although there are many accessories in the marketplace, such as ovulation test kits or monitors, tracking your menstrual cycle and having intercourse (sex) within a specific time frame is more important.

Sometimes people get anxious and don’t have enough sex because they wait for specific test parameters to change. If you’re just starting to try to conceive, the idea is to have sex one to two days prior to and on the day of ovulation. For most couples, having regular intercourse two to three times per week beginning soon after the woman’s period ends will ensure intercourse falls within the fertile window.

What are some options available for those who are struggling to naturally conceive after 35?
If you’re over 35 and have been attempting to conceive for at least 6 months, don’t delay talking with your physician. It doesn’t mean you are committing to any treatment. It simply means you are having a discussion with a reproductive endocrinologist to go over factors that may be hindering your chances of getting pregnant. It is a diagnostic evaluation.

I recommend that partners try on their own to get pregnant before going in for an evaluation. If you’re between the ages of 35 to 39, attempt for six months to conceive. If you’re 40 to 42, attempt for three months prior to an evaluation. If you’re between the ages of 42 to 45 or older, I recommend speaking with a physician before trying to conceive to discuss reproductive goals to optimize your opportunities.

What advice would you give someone who is worried they are too old to conceive?
Although it can certainly be anxiety-producing for some, it’s good to arm yourself with accurate, research-backed data because there are a lot of fertility myths out there. The good news is there are many options available to help you conceive, and technology continues to improve to allow more pathways to parenthood.