Women nowadays are deciding to have a baby later in life. Many prioritize first establishing stable living conditions, advancing their careers, and finding a committed partnership. The average age in Germany for having the first child has increased significantly in recent years: while it was in the late 20s a decade ago, it is now in the mid-30s. Pregnancy at 40 is also becoming an option for more and more women. But can this late desire for children align with the biological clock? We'll explain what you need to consider when trying to conceive at 40 and how you can still fulfill your dream of starting a family.
Fact: Fertility declines after 30
Fertility gradually decreases after the age of 30. This does not mean that getting pregnant becomes impossible. It simply means that the chances of conceiving decrease somewhat.
While the probability of getting pregnant (without medical conditions) for younger women in their thirties is around 75%, it decreases to only 40-50% at forty and continues to decline steadily.
Myth: Pregnancy at 40 is impossible
A common myth surrounding the desire to have a child at 40 is that pregnancy at this age is nearly impossible. While it is true that fertility decreases with age and the risk of complications during pregnancy increases, it is still possible to get pregnant at 40.
Fact: Egg reserve decreases with age
Unlike men, women are somewhat limited in terms of fertility. While sperm is regenerated throughout a man's life, the supply of eggs in the female ovaries is unfortunately limited.
A woman's egg reserve is determined at birth and gradually decreases throughout her life. At the onset of puberty, there are around 500,000 immature eggs in the ovaries, but this number decreases with each menstrual cycle. At the same time, the likelihood of genetically abnormal eggs increases due to faulty division processes or unhealthy environmental influences (such as nicotine, alcohol, inflammation, pollutants). Additionally, as the production of female hormones decreases, many women assess their fertility using the Anti-Müllerian hormone (AMH) level.
The Anti-Müllerian Hormone (AMH) level is a marker commonly used to assess a woman's egg reserve. It is produced by the granulosa cells in the ovaries and reflects the number of eggs remaining available to a woman. A low AMH level may indicate a reduced egg reserve, while a high level may indicate a larger number of remaining eggs.
However, the AMH level is only an indicator and cannot be solely used to determine a woman's fertility. From a medical perspective, there are some criticisms of the AMH level, such as the potential variability from lab to lab and the limited predictive power since other factors such as a woman's age, the regularity of her menstrual cycles, and the health of the uterus also need to be considered.
Myth: Pregnancy only possible with IVF
A myth is that women over 40 automatically require in vitro fertilization (IVF) to get pregnant. While IVF can be helpful in some cases, it is not always necessary, and many women of this age can conceive naturally.
Fact: Increased risk of complications
However, it is a fact that the risk of complications during pregnancy increases with age.
In particular, the risk of Down syndrome (Trisomy 21) in newborns significantly increases in expectant mothers over 40. This is due to an error in chromosome division: as women age, the body lacks the necessary energy for the flawless execution of meiosis, the cell division that leads to the formation of eggs. Additionally, repair mechanisms become less efficient. With advancing age, a woman's cell repair mechanisms may work less efficiently to correct errors in chromosome division. This results in chromosome 21 being present in triplicate instead of duplicate.
Other common problems with pregnancy at an advanced age include:
- High blood pressure
- Gestational diabetes
- Bleeding
- Anemia
- Gestosis
- Preeclampsia It is important for women at this age to be aware of these risks and, if necessary, seek genetic counseling to make informed decisions about their family planning.
Conclusion: Pregnancy successful in many cases
There is no specific age limit until which a woman can get pregnant. Even at 40, natural or artificial fertilization can still be successful, and the desire to have children can be fulfilled.
However, the prerequisites are:
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Regular menstrual cycle with ovulation
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Good immune and hormone status
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No chronic infections
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No organic diseases or genetic predispositions
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Adequate sperm quality of the partner If there are already children for whom the pregnancy went smoothly, chances are good that there will be no complications with a later attempt. Nevertheless, certain precautions should be taken before planned pregnancy in any case. These include:
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A healthy lifestyle (healthy diet, sufficient exercise, minimal stress, abstaining from alcohol, cigarettes, and drugs)
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Supplementary intake of micronutrients (especially folic acid)
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Additional, close monitoring (such as doctor consultations, ultrasounds, amniocentesis, etc.)
Late motherhood is generally not an obstacle, and you can still start your family even at 40.
