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Getting Pregnant After 40: Fertility Care Options

Did you know that women are born with all the eggs they’ll ever have – and the quality and quantity of eggs decreases as women age? This concept is known as “Ovarian Reserve” – the quantity and quality of eggs remaining in the ovaries. Due to diminished ovarian reserve, many women may find it difficult to conceive over the age of 40. Below, please find an overview of the treatment options available for women 40+ hoping to grow their family.

Fertility Health Screening

For women hoping to conceive over the age of 40, we recommend a comprehensive Fertility Health Screening as the first step in the care journey. This screening will include bloodwork to assess your Anti-Mullerian Hormone (“AMH”) and Follicle-Stimulating Hormone (“FSH”) levels, both of which are good indicators of your ovarian reserve. It will also include an ultrasound to evaluate your Antral Follicle Count (the number of follicles contained within your ovaries helps your physician to determine how many eggs may be produced in any given month). The results of your Fertility Health Screening can be used to assess your future family-building options and to determine if fertility treatment is right for you.

Lifestyle Measures

The below lifestyle measures are recommended to help increase the likelihood of achieving pregnancy. While they are not intended to be a substitute for medical care, the below, in conjunction with medical treatment, may improve the odds of conceiving a healthy baby:

• Regular exercise
• Maintain a healthy BMI
• No smoking
• Limit caffeine
• Limit the consumption of alcoholic beverages (less than 2 drinks per day)
• Keep track of your cycle

IVF with PGT

In Vitro Fertilization (IVF) is the most common course of care for women over 40 hoping to conceive. During a natural menstrual cycle, the brain produces hormones that stimulate one of the ovaries to release an egg. During an ovulation induction cycle, you are prescribed those same hormones, known as fertility medications, to stimulate the ovaries to mature numerous eggs at once. If more eggs are matured, more can be retrieved and used to create embryos. Most often, this improves the chances of fertilization, and ultimately pregnancy.

For women over 40, we strongly recommend the addition of Preimplantation Genetic Testing (PGT) to your IVF cycle. Preimplantation genetic testing for aneuploidy (PGT-A) allows us to count the number of chromosomes in an embryo biopsy. A euploid or “normal” embryo contains 23 pairs of chromosomes, though abnormalities in chromosome number (i.e. too many or too few, or structural defects) are common and their incidence increases as women age. In some cases, these abnormalities can lead to miscarriage and other health concerns. PGT-A testing reduces the risk of miscarriage by reducing the chance of transferring a genetically abnormal embryo.

Donor Eggs

For women over 40 whose eggs may not be viable, building a family with the help of donor eggs may be advised to achieve your dream of parenthood. We understand that the decision to build your family with the help of an egg donor is both an emotional and a medical journey. At NYU Langone Fertility Center, we maintain the highest level of discretion and support for both patients and donors. Our dedicated in-house Donor Egg team assists patients, locally and internationally, with the selection of the right egg donor for each family.

When it comes to donor egg services, you have options. In a “fresh egg donation cycle,” a pre-screened and approved egg donor is stimulated at NYU Langone Fertility Center. In a “frozen egg donation cycle,” frozen eggs from a pre-screened, approved egg donor are thawed at NYU Langone Fertility Center, then fertilized with sperm from the intended parent or sperm donor. Whether you choose to pursue a fresh or frozen egg donation cycle, our Donor Egg team will work with you to identify the best fit for your family.

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