Q: I am 41 years old. How can I have a healthy pregnancy?

A. There is no question that fertility, your chances of getting pregnant, is affected by a woman's age. The older you are, the less likely your chance of getting pregnant. This is due to the age of your ovaries and your eggs, and there is little a woman can do about this.

However, a woman should not assume automatically that just because she has reached age 40, she cannot have a healthy pregnancy. Getting pregnant may be more difficult, but that doesn’t mean the pregnancy itself will be. Statistically, a woman’s chances to conceive starts to decline in her early 30s, but age isn’t the most important factor.

A healthy 41-year-old woman, though she may have more difficulty getting pregnant,  has a better chance of having a safe pregnancy than an unhealthy 30-year-old. Anyone who’s trying to conceive should aim for overall good health. The most important factors are:

Your weight affects your pregnancy

Obese and underweight women will have a harder time getting pregnant and will be at higher risk for miscarriage if they do become pregnant. Women should aim for a body mass index (BMI) between 18.5 and 24.9. Calculate your BMI.

Drugs

Smoking and excessive alcohol are toxic to the reproductive system and have detrimental effects on a woman’s egg supply and the eggs themselves. If you need help quitting, try a smoking cessation class or a support group for alcohol addiction. Also, try to get at least eight hours of sleep per night to restore your body.

Nutrition 

A healthy diet contributes to your overall health and to the health of your fetus, should you become get pregnant.

Q: When should I seek help from the reproductive specialist?

A: Typically, patients whose a specialist have tried to conceive naturally anywhere from six months to a year, and sometimes longer. We actually define infertility as the inability to conceive after one year of unprotected intercourse. In women over 35 years old, the diagnosis of infertility is often given after six months of trying to conceive. In most cases, these women have already undergone a basic evaluation and some initial treatments with their Ob-Gyn.

While the causes of infertility are not always clear, the most common culprits include sperm abnormalities, fallopian tube disease, ovulation disorders, and uterine abnormalities. In about 10 percent of cases, a cause cannot be determined.

Q: If I have infertility, what are my treatment options?

A: Treatment will depend on the cause of infertility. For some couples, a woman simply needs to undergo well-timed intercourse or artificial insemination. Centers offer artificial inseminations, pelvic surgery, medications to induce ovulation, in-vitro fertilization, egg donation, and, in certain scenarios, the preservation or freezing of embryos. 

After a review of your medical history, diagnostic tests are run that might include

• examining a woman’s hormone levels,
• conducting a pelvic and transvaginal sonogram to examine the ovaries, uterus and fallopian tubes and
• doing a semen analysis for the man when necessary.

Q: If I do get pregnant, will I have certain risk factors? 

A: After your eighth week of pregnancy, you’ll return to your regular Ob-Gyn who will screen for any abnormalities and closely monitor you throughout the pregnancy. Even if we detect something is wrong, we can offer family counseling and keep mom and baby healthy. After age 40, the risk can be higher for miscarriage, infection, hemorrhaging, high blood pressure, and chromosomal or genetic abnormalities, such as Down’s syndrome.

Q: I’m thinking about becoming pregnant in my late 30s or early 40s. Do you have any advice?

A: Get evaluated by a fertility specialist early on. Even women who are in their early 30s who are not ready to start a family should talk to their Ob-Gyn about fertility. A specialist can take the time to assess their reproductive and ovarian function, possibly offer embryo preservation, and answer any questions about starting a family later in life.