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Pregnant At 40 Risks: Is a pregnancy after the age of 40 reasonable?

T he average age of a first pregnancy is steadily decreasing. Late pregnancies are becoming more and more common today. But are the risks hi...

The average age of a first pregnancy is steadily decreasing. Late pregnancies are becoming more and more common today. But are the risks higher? How can we put all the chances on our side? Adrien Gaudineau, gynecologist-obstetrician, reviews these particular pregnancies that require specific follow-up.

Pregnant At 40 Risks

Late pregnancies after the age of 40 remain quite rare in France, and exceptional when they are spontaneous. Pregnancy after a certain age can become dangerous for both mother and child. A personalized follow-up is then necessary for these future mothers. Adrien Gaudineau, gynecologist-obstetrician at the University Hospitals of Strasbourg, gives some explanations and recommendations on these pregnancies, which are more complex after the age of 40.

The body after the age of 40

A young woman between the ages of 18 and 25 has an average 25% probability of conceiving a child in each cycle. For a woman aged 40-42, her cycle drops significantly to 6%. Fertility becomes almost nil around the age of 45. The aging of the ovaries is one of the reasons why female fertility, i.e. the ability to become pregnant, decreases with age. 

Assisted procreation to get pregnant

Conceiving a child late in life is not always easy. More than half of all pregnancies after the age of 40 result from medically assisted reproduction. The techniques are many and varied, but do not apply to all women wishing to have a child:

  • Simple ovarian stimulation: it can be performed alone or accompanied by artificial insemination or in vitro fertilization. These are the two most common treatments. Women with impaired ovulation will have recourse to this practice, which allows them to regain ovulation.
  • Artificial insemination with the spouse's sperm: insemination is nowadays done intrauterine. It is indicated in women with an abnormal cervix, in case of mucus that is not receptive to the semen or in case of ejaculation problems on the part of the spouse.

In vitro fertilization: the meeting between the egg and the sperm is promoted by a laboratory. This technique is used in cases of early infertility, after several natural tests or with medical help.

The menopause puts an end to a possible pregnancy.

What is menopause? If there has been no menstruation for at least a year, due to the exhaustion of the ovarian follicles, it is called menopause. For a young woman, the stock of eggs is already constituted and is not renewed, unlike sperm. However, a woman can theoretically have a pregnancy from puberty to menopause, which generally occurs between the ages of 45 and 55.

Specific risks during late pregnancy

Real risks must be taken into account during pregnancy after 40 years of age.

The most common signs

The later a pregnancy occurs, the greater the risk of miscarriage. They are very frequent in the first trimester, and exceed 30% after the age of 40. There are also other important risks to take into account:

  • High blood pressure: this abnormally high pressure in the blood and arteries can lead to intrauterine growth retardation and placental detachment.
  • Pregnancy diabetes or gestational diabetes: this disorder of blood sugar regulation occurs only during pregnancy. Diabetes can lead to many complications, including malformation of the fetus.
  • premature delivery: late pregnancy increases the risk of premature birth.

Of course, women who become pregnant at a later age often experience more pregnancy-related discomfort.

The chromosomal abnormality

The other consequence of the aging of the eggs concerns the risk of chromosomal anomalies, such as trisomy 21, which increases with age. At age 40, the risk of trisomy 21 is around 1%. Although men produce sperm all their lives and the impact of age on sperm quality is less, the chances of conception also decrease over time, while genetic risks increase.

Pregnancy after the age of 40, possible under certain conditions.

However, it is not unreasonable to start a pregnancy at an advanced age. It is important to be in excellent physical shape and to be aware that fertility is reduced and certain risks are increased.

Pregnancies to be closely monitored

Pregnancy after 38-40 years of age generally goes well. These pregnancies are more closely monitored, with optimal treatment or surveillance. It is therefore better to consult a doctor beforehand to find out about potential complications. This is one of the reasons why in France, it is rare for medical teams to accede to a request for medically assisted procreation after the age of 45, using another woman's eggs.

A more serene pregnancy so well prepared

Thanks to all the precautions taken and fears alleviated, the mother-to-be can enjoy her pregnancy to the fullest. Well prepared and aware of the need for special monitoring, women over 40 years of age can approach their pregnancy with serenity. She knows that it will surely be her only child and will make the most of her magical moments as a mother-to-be.

Reference Adrien Gaudineau, gynecologist-obstetrician at the University Hospitals of Strasbourg

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